How much rates vary
Facilitymedian $8,511 · 10th to 90th $891 to $18,197Professionalmedian $7,943 · 10th to 90th $2,951 to $19,055
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $14,454.40 | Facility | None | $2,951.21 | $2,951.21 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $48,977.88 | Professional | None | $2,951.21 | $2,951.21 | $48,977.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $12,589.25 Typical High $19,952.62 | Facility | None | $10,000.00 | $12,589.25 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,511.89 Median $8,912.51 Typical High $19,054.61 | Professional | None | $2,511.89 | $8,912.51 | $19,054.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $5,623.41 Typical High $12,022.64 | Professional | 62 · Two surgeons | $1,584.89 | $5,623.41 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $1,445.44 Typical High $3,090.30 | Professional | 80 · Assistant surgeon | $407.38 | $1,445.44 | $3,090.30 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $1,258.93 Typical High $2,691.53 | Professional | AS · PA/NP assist | $354.81 | $1,258.93 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,623.41 Typical High $8,709.64 | Facility | None | $812.83 | $5,623.41 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $6,918.31 Typical High $12,022.64 | Professional | None | $3,801.89 | $6,918.31 | $12,022.64 |
DeanCare Setting Facility Modifier None Typical Low $2,570.40 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,570.40 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $4,677.35 Median $5,754.40 Typical High $7,762.47 | Professional | None | $4,677.35 | $5,754.40 | $7,762.47 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,691.53 Typical High $18,197.01 | Facility | None | $436.52 | $2,691.53 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,884.03 Median $8,128.31 Typical High $12,882.50 | Professional | None | $2,884.03 | $8,128.31 | $12,882.50 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $3,311.31 Typical High $4,897.79 | Facility | None | $2,089.30 | $3,311.31 | $4,897.79 |
Network Health Setting Professional Modifier None Typical Low $3,235.94 Median $5,495.41 Typical High $7,762.47 | Professional | None | $3,235.94 | $5,495.41 | $7,762.47 |
Prevea360 Setting Facility Modifier None Typical Low $1,995.26 Median $2,754.23 Typical High $4,786.30 | Facility | None | $1,995.26 | $2,754.23 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $2,398.83 Median $5,623.41 Typical High $10,232.93 | Professional | None | $2,398.83 | $5,623.41 | $10,232.93 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $5,248.07 | Professional | None | $3,801.89 | $3,801.89 | $5,248.07 |
Security Health Setting Professional Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | None | $11,481.54 | $11,481.54 | $11,481.54 |
Security Health Setting Professional Modifier None Typical Low $10,715.19 Median $14,454.40 Typical High $16,218.10 | Professional | None | $10,715.19 | $14,454.40 | $16,218.10 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $2,630.27 Median $8,128.31 Typical High $12,589.25 | Professional | None | $2,630.27 | $8,128.31 | $12,589.25 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,445.44 Median $1,445.44 Typical High $24,547.09 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $24,547.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $588.84 Typical High $10,000.00 | Professional | 53 · Discontinued | $588.84 | $588.84 | $10,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,187.76 Typical High $37,153.52 | Professional | 54 · Surgery only | $2,187.76 | $2,187.76 | $37,153.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $436.52 Typical High $7,413.10 | Professional | 55 · Aftercare only | $436.52 | $436.52 | $7,413.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $295.12 Typical High $4,897.79 | Professional | 56 · Pre-op care only | $295.12 | $295.12 | $4,897.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,041.74 Typical High $34,673.69 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,041.74 | $34,673.69 |
Where Wisconsin sits
The same service costs 5.8 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wisconsin· 2nd of 51
$8,128
AK $9,333TX $1,622
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.