How much rates vary
Facilitymedian $8,710 · 10th to 90th $891 to $18,197Professionalmedian $10,965 · 10th to 90th $3,981 to $22,909
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 $3,981.07 Median $3,981.07 Typical High $14,454.40 | Facility | None | $3,981.07 | $3,981.07 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $31,622.78 | Professional | None | $3,981.07 | $3,981.07 | $31,622.78 |
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 $3,467.37 Median $12,302.69 Typical High $24,547.09 | Professional | None | $3,467.37 | $12,302.69 | $24,547.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $1,949.84 Typical High $3,981.07 | Professional | 80 · Assistant surgeon | $549.54 | $1,949.84 | $3,981.07 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $478.63 Median $1,737.80 Typical High $3,467.37 | Professional | AS · PA/NP assist | $478.63 | $1,737.80 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $7,585.78 Typical High $11,748.98 | Facility | None | $812.83 | $7,585.78 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $5,128.61 Median $9,332.54 Typical High $16,595.87 | Professional | None | $5,128.61 | $9,332.54 | $16,595.87 |
DeanCare Setting Facility Modifier None Typical Low $3,467.37 Median $7,943.28 Typical High $14,791.08 | Facility | None | $3,467.37 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $6,309.57 Median $7,943.28 Typical High $10,715.19 | Professional | None | $6,309.57 | $7,943.28 | $10,715.19 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,818.38 Typical High $18,197.01 | Facility | None | $436.52 | $2,818.38 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $4,073.80 Median $10,964.78 Typical High $17,782.79 | Professional | None | $4,073.80 | $10,964.78 | $17,782.79 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $4,466.84 Typical High $6,309.57 | Facility | None | $2,089.30 | $4,466.84 | $6,309.57 |
Network Health Setting Professional Modifier None Typical Low $4,365.16 Median $7,413.10 Typical High $10,000.00 | Professional | None | $4,365.16 | $7,413.10 | $10,000.00 |
Prevea360 Setting Facility Modifier None Typical Low $2,754.23 Median $3,467.37 Typical High $6,760.83 | Facility | None | $2,754.23 | $3,467.37 | $6,760.83 |
Quartz Setting Professional Modifier None Typical Low $3,311.31 Median $7,585.78 Typical High $13,803.84 | Professional | None | $3,311.31 | $7,585.78 | $13,803.84 |
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 $5,128.61 Median $5,128.61 Typical High $7,079.46 | Professional | None | $5,128.61 | $5,128.61 | $7,079.46 |
Security Health Setting Professional Modifier None Typical Low $15,488.17 Median $15,488.17 Typical High $15,488.17 | Professional | None | $15,488.17 | $15,488.17 | $15,488.17 |
Security Health Setting Professional Modifier None Typical Low $14,454.40 Median $19,498.45 Typical High $21,877.62 | Professional | None | $14,454.40 | $19,498.45 | $21,877.62 |
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 $3,630.78 Median $10,964.78 Typical High $16,982.44 | Professional | None | $3,630.78 | $10,964.78 | $16,982.44 |
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 $1,995.26 Median $1,995.26 Typical High $15,848.93 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $15,848.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $6,309.57 | Professional | 53 · Discontinued | $794.33 | $794.33 | $6,309.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $2,951.21 Typical High $23,988.33 | Professional | 54 · Surgery only | $2,951.21 | $2,951.21 | $23,988.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $4,786.30 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $4,786.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $3,162.28 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $3,162.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $2,754.23 Typical High $22,387.21 | Professional | 78 · Unplanned return to OR | $2,754.23 | $2,754.23 | $22,387.21 |
Where Wisconsin sits
The same service costs 7.1 times more in Alaska than in Arkansas. 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
$10,233
AK $12,882AR $1,820
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.