How much rates vary
Facilitymedian $8,710 · 10th to 90th $891 to $18,197Professionalmedian $11,749 · 10th to 90th $4,266 to $24,547
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 $4,265.80 Median $4,265.80 Typical High $14,454.40 | Facility | None | $4,265.80 | $4,265.80 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $35,481.34 | Professional | None | $4,265.80 | $4,265.80 | $35,481.34 |
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 $3,630.78 Median $12,882.50 Typical High $26,915.35 | Professional | None | $3,630.78 | $12,882.50 | $26,915.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $2,041.74 Typical High $4,265.80 | Professional | 80 · Assistant surgeon | $588.84 | $2,041.74 | $4,265.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $1,819.70 Typical High $3,715.35 | Professional | AS · PA/NP assist | $512.86 | $1,819.70 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $8,317.64 Typical High $12,589.25 | Facility | None | $812.83 | $8,317.64 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $5,623.41 Median $10,232.93 Typical High $17,782.79 | Professional | None | $5,623.41 | $10,232.93 | $17,782.79 |
DeanCare Setting Facility Modifier None Typical Low $3,801.89 Median $7,943.28 Typical High $14,791.08 | Facility | None | $3,801.89 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $6,918.31 Median $8,511.38 Typical High $11,481.54 | Professional | None | $6,918.31 | $8,511.38 | $11,481.54 |
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 $4,466.84 Median $11,748.98 Typical High $19,054.61 | Professional | None | $4,466.84 | $11,748.98 | $19,054.61 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $4,786.30 Typical High $6,760.83 | Facility | None | $2,089.30 | $4,786.30 | $6,760.83 |
Network Health Setting Professional Modifier None Typical Low $4,677.35 Median $8,128.31 Typical High $10,964.78 | Professional | None | $4,677.35 | $8,128.31 | $10,964.78 |
Prevea360 Setting Facility Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $7,244.36 | Facility | None | $2,951.21 | $3,801.89 | $7,244.36 |
Quartz Setting Professional Modifier None Typical Low $3,548.13 Median $8,128.31 Typical High $14,791.08 | Professional | None | $3,548.13 | $8,128.31 | $14,791.08 |
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 $5,623.41 Median $5,623.41 Typical High $7,585.78 | Professional | None | $5,623.41 | $5,623.41 | $7,585.78 |
Security Health Setting Professional Modifier None Typical Low $16,982.44 Median $16,982.44 Typical High $16,982.44 | Professional | None | $16,982.44 | $16,982.44 | $16,982.44 |
Security Health Setting Professional Modifier None Typical Low $15,848.93 Median $20,892.96 Typical High $23,988.33 | Professional | None | $15,848.93 | $20,892.96 | $23,988.33 |
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 $3,890.45 Median $12,022.64 Typical High $18,620.87 | Professional | None | $3,890.45 | $12,022.64 | $18,620.87 |
4 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 $2,137.96 Median $2,137.96 Typical High $17,782.79 | Professional | 52 · Reduced service | $2,137.96 | $2,137.96 | $17,782.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $7,079.46 | Professional | 53 · Discontinued | $851.14 | $851.14 | $7,079.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,235.94 Median $3,235.94 Typical High $26,302.68 | Professional | 54 · Surgery only | $3,235.94 | $3,235.94 | $26,302.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,019.95 Median $3,019.95 Typical High $24,547.09 | Professional | 78 · Unplanned return to OR | $3,019.95 | $3,019.95 | $24,547.09 |
Where Wisconsin sits
The same service costs 7.6 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
$10,965
AK $13,804AR $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.