How much rates vary
Facilitymedian $10,965 · 10th to 90th $794 to $22,387Professionalmedian $8,511 · 10th to 90th $2,951 to $19,953
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 $3,235.94 Median $3,235.94 Typical High $14,454.40 | Facility | None | $3,235.94 | $3,235.94 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $13,182.57 Median $18,620.87 Typical High $25,703.96 | Facility | None | $13,182.57 | $18,620.87 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $11,220.18 Typical High $23,442.29 | Professional | None | $3,162.28 | $11,220.18 | $23,442.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $1,819.70 Typical High $3,715.35 | Professional | 80 · Assistant surgeon | $501.19 | $1,819.70 | $3,715.35 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $1,584.89 Typical High $3,311.31 | Professional | AS · PA/NP assist | $436.52 | $1,584.89 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $3,630.78 | Facility | None | $645.65 | $1,071.52 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $9,332.54 | Professional | None | $5,011.87 | $8,317.64 | $9,332.54 |
DeanCare Setting Facility Modifier None Typical Low $3,235.94 Median $7,943.28 Typical High $14,791.08 | Facility | None | $3,235.94 | $7,943.28 | $14,791.08 |
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 $2,754.23 Median $8,511.38 Typical High $14,125.38 | Professional | None | $2,754.23 | $8,511.38 | $14,125.38 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | None | $8,128.31 | $8,128.31 | $8,128.31 |
Prevea360 Setting Facility Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,235.94 | $5,128.61 |
Quartz Setting Professional Modifier None Typical Low $2,630.27 Median $5,370.32 Typical High $7,762.47 | Professional | None | $2,630.27 | $5,370.32 | $7,762.47 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $3,630.78 | Facility | None | $645.65 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,248.07 | Professional | None | $5,011.87 | $5,011.87 | $5,248.07 |
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 $2,691.53 Median $8,709.64 Typical High $13,803.84 | Professional | None | $2,691.53 | $8,709.64 | $13,803.84 |
5 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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $323.59 | $323.59 | $323.59 |
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
$8,913
AK $10,471AR $1,479
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.