How much rates vary
Facilitymedian $8,318 · 10th to 90th $891 to $18,197Professionalmedian $4,677 · 10th to 90th $1,738 to $10,471
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 $1,737.80 Median $1,737.80 Typical High $14,454.40 | Facility | None | $1,737.80 | $1,737.80 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $24,547.09 | Professional | None | $1,737.80 | $1,737.80 | $24,547.09 |
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 $1,513.56 Median $5,248.07 Typical High $11,481.54 | Professional | None | $1,513.56 | $5,248.07 | $11,481.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $3,311.31 Typical High $6,760.83 | Professional | 62 · Two surgeons | $954.99 | $3,311.31 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $851.14 Typical High $1,698.24 | Professional | 80 · Assistant surgeon | $239.88 | $851.14 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $741.31 Typical High $1,479.11 | Professional | AS · PA/NP assist | $208.93 | $741.31 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,388.44 Typical High $5,128.61 | Facility | None | $812.83 | $3,388.44 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $4,073.80 Typical High $7,244.36 | Professional | None | $2,238.72 | $4,073.80 | $7,244.36 |
DeanCare Setting Facility Modifier None Typical Low $1,513.56 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,513.56 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,818.38 Median $3,467.37 Typical High $4,570.88 | Professional | None | $2,818.38 | $3,467.37 | $4,570.88 |
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 $1,698.24 Median $4,786.30 Typical High $7,585.78 | Professional | None | $1,698.24 | $4,786.30 | $7,585.78 |
Network Health Setting Facility Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,754.23 | Facility | None | $1,949.84 | $2,089.30 | $2,754.23 |
Network Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,311.31 Typical High $4,570.88 | Professional | None | $1,905.46 | $3,311.31 | $4,570.88 |
Prevea360 Setting Facility Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,818.38 | Facility | None | $1,202.26 | $1,659.59 | $2,818.38 |
Quartz Setting Professional Modifier None Typical Low $1,479.11 Median $3,388.44 Typical High $5,888.44 | Professional | None | $1,479.11 | $3,388.44 | $5,888.44 |
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 $2,238.72 Median $2,238.72 Typical High $3,090.30 | Professional | None | $2,238.72 | $2,238.72 | $3,090.30 |
Security Health Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,760.83 | $6,760.83 | $6,760.83 |
Security Health Setting Professional Modifier None Typical Low $6,309.57 Median $8,511.38 Typical High $9,549.93 | Professional | None | $6,309.57 | $8,511.38 | $9,549.93 |
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 $1,548.82 Median $4,786.30 Typical High $7,413.10 | Professional | None | $1,548.82 | $4,786.30 | $7,413.10 |
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 $870.96 Median $870.96 Typical High $12,302.69 | Professional | 52 · Reduced service | $870.96 | $870.96 | $12,302.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $4,897.79 | Professional | 53 · Discontinued | $346.74 | $346.74 | $4,897.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $18,620.87 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $18,620.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $3,715.35 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $3,715.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $2,454.71 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $2,454.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $17,378.01 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $17,378.01 |
Where Wisconsin sits
The same service costs 5.4 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
$5,012
AK $5,495TX $1,023
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.