How much rates vary
Facilitymedian $8,318 · 10th to 90th $891 to $18,197Professionalmedian $3,890 · 10th to 90th $1,445 to $8,710
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 $1,445.44 Median $1,445.44 Typical High $14,454.40 | Facility | None | $1,445.44 | $1,445.44 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $14,125.38 | Professional | None | $1,445.44 | $1,445.44 | $14,125.38 |
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 $1,230.27 Median $4,365.16 Typical High $9,549.93 | Professional | None | $1,230.27 | $4,365.16 | $9,549.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $2,754.23 Typical High $5,495.41 | Professional | 62 · Two surgeons | $776.25 | $2,754.23 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $707.95 Typical High $1,412.54 | Professional | 80 · Assistant surgeon | $199.53 | $707.95 | $1,412.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $616.60 Typical High $1,230.27 | Professional | AS · PA/NP assist | $173.78 | $616.60 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,754.23 Typical High $4,265.80 | Facility | None | $812.83 | $2,754.23 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $3,388.44 Typical High $6,025.60 | Professional | None | $1,862.09 | $3,388.44 | $6,025.60 |
DeanCare Setting Facility Modifier None Typical Low $1,258.93 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,258.93 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $3,801.89 | Professional | None | $2,290.87 | $2,818.38 | $3,801.89 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $3,890.45 Typical High $6,309.57 | Professional | None | $1,412.54 | $3,890.45 | $6,309.57 |
Network Health Setting Facility Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,290.87 | Facility | None | $1,621.81 | $2,089.30 | $2,290.87 |
Network Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,691.53 Typical High $3,715.35 | Professional | None | $1,584.89 | $2,691.53 | $3,715.35 |
Prevea360 Setting Facility Modifier None Typical Low $977.24 Median $1,380.38 Typical High $2,398.83 | Facility | None | $977.24 | $1,380.38 | $2,398.83 |
Quartz Setting Professional Modifier None Typical Low $1,202.26 Median $2,754.23 Typical High $4,897.79 | Professional | None | $1,202.26 | $2,754.23 | $4,897.79 |
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 $1,862.09 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,862.09 | $1,862.09 | $2,570.40 |
Security Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
Security Health Setting Professional Modifier None Typical Low $5,248.07 Median $6,918.31 Typical High $7,943.28 | Professional | None | $5,248.07 | $6,918.31 | $7,943.28 |
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 $1,288.25 Median $3,890.45 Typical High $6,025.60 | Professional | None | $1,288.25 | $3,890.45 | $6,025.60 |
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 $724.44 Median $724.44 Typical High $7,079.46 | Professional | 52 · Reduced service | $724.44 | $724.44 | $7,079.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $2,818.38 | Professional | 53 · Discontinued | $288.40 | $288.40 | $2,818.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $10,471.29 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $10,471.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $2,137.96 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $2,137.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $1,412.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $1,412.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $9,772.37 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $9,772.37 |
Where Wisconsin sits
The same service costs 5.6 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
$4,266
AK $4,571TX $813
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.