How much rates vary
Facilitymedian $10,471 · 10th to 90th $794 to $22,387Professionalmedian $5,495 · 10th to 90th $1,905 to $11,482
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 $2,344.23 Median $2,344.23 Typical High $14,454.40 | Facility | None | $2,344.23 | $2,344.23 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
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 $2,041.74 Median $7,244.36 Typical High $13,489.63 | Professional | None | $2,041.74 | $7,244.36 | $13,489.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $1,174.90 Typical High $2,187.76 | Professional | 80 · Assistant surgeon | $323.59 | $1,174.90 | $2,187.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $1,023.29 Typical High $1,905.46 | Professional | AS · PA/NP assist | $281.84 | $1,023.29 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $2,691.53 | Facility | None | $645.65 | $954.99 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $5,248.07 Typical High $6,025.60 | Professional | None | $2,691.53 | $5,248.07 | $6,025.60 |
DeanCare Setting Facility Modifier None Typical Low $2,238.72 Median $7,943.28 Typical High $14,791.08 | Facility | None | $2,238.72 | $7,943.28 | $14,791.08 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,570.40 Typical High $18,197.01 | Facility | None | $436.52 | $2,570.40 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $5,495.41 Typical High $9,120.11 | Professional | None | $1,698.24 | $5,495.41 | $9,120.11 |
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 $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Prevea360 Setting Facility Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $3,548.13 | Facility | None | $1,949.84 | $2,238.72 | $3,548.13 |
Quartz Setting Professional Modifier None Typical Low $1,905.46 Median $3,981.07 Typical High $5,623.41 | Professional | None | $1,905.46 | $3,981.07 | $5,623.41 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $2,691.53 | Facility | None | $645.65 | $954.99 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,818.38 | Professional | None | $2,691.53 | $2,691.53 | $2,818.38 |
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 $1,621.81 Median $5,623.41 Typical High $8,912.51 | Professional | None | $1,621.81 | $5,623.41 | $8,912.51 |
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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $234.42 |
Where Wisconsin sits
The same service costs 5.2 times more in Alaska than in Maryland. 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
$6,026
AK $7,244MD $1,380
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.