How much rates vary
Facilitymedian $9,550 · 10th to 90th $832 to $18,197Professionalmedian $8,318 · 10th to 90th $2,692 to $21,380
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 $2,754.23 Median $2,754.23 Typical High $14,454.40 | Facility | None | $2,754.23 | $2,754.23 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $37,153.52 | Professional | None | $2,754.23 | $2,754.23 | $37,153.52 |
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 $2,630.27 Median $8,511.38 Typical High $18,197.01 | Professional | None | $2,630.27 | $8,511.38 | $18,197.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $1,380.38 Typical High $2,951.21 | Professional | 80 · Assistant surgeon | $426.58 | $1,380.38 | $2,951.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $1,202.26 Typical High $2,570.40 | Professional | AS · PA/NP assist | $371.54 | $1,202.26 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $10,715.19 Typical High $16,218.10 | Facility | None | $758.58 | $10,715.19 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $4,265.80 Median $10,000.00 Typical High $14,791.08 | Professional | None | $4,265.80 | $10,000.00 | $14,791.08 |
DeanCare Setting Facility Modifier None Typical Low $4,570.88 Median $7,943.28 Typical High $14,791.08 | Facility | None | $4,570.88 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Professional | None | $11,748.98 | $11,748.98 | $11,748.98 |
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 $2,570.40 Median $13,182.57 Typical High $20,417.38 | Professional | None | $2,570.40 | $13,182.57 | $20,417.38 |
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 $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
Prevea360 Setting Facility Modifier None Typical Low $2,754.23 Median $4,570.88 Typical High $8,128.31 | Facility | None | $2,754.23 | $4,570.88 | $8,128.31 |
Quartz Setting Professional Modifier None Typical Low $2,187.76 Median $4,466.84 Typical High $6,456.54 | Professional | None | $2,187.76 | $4,466.84 | $6,456.54 |
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 $4,265.80 Median $4,265.80 Typical High $4,466.84 | Professional | None | $4,265.80 | $4,265.80 | $4,466.84 |
Security Health Setting Professional Modifier None Typical Low $20,892.96 Median $20,892.96 Typical High $20,892.96 | Professional | None | $20,892.96 | $20,892.96 | $20,892.96 |
Security Health Setting Professional Modifier None Typical Low $22,908.68 Median $28,840.32 Typical High $31,622.78 | Professional | None | $22,908.68 | $28,840.32 | $31,622.78 |
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 $2,570.40 Median $13,489.63 Typical High $20,892.96 | Professional | None | $2,570.40 | $13,489.63 | $20,892.96 |
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 $1,380.38 Median $1,380.38 Typical High $18,620.87 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $18,620.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $7,413.10 | Professional | 53 · Discontinued | $549.54 | $549.54 | $7,413.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,041.74 Typical High $27,542.29 | Professional | 54 · Surgery only | $2,041.74 | $2,041.74 | $27,542.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $407.38 Typical High $5,495.41 | Professional | 55 · Aftercare only | $407.38 | $407.38 | $5,495.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $3,715.35 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $3,715.35 |
Where Wisconsin sits
The same service costs 5.6 times more in Alaska than in South Carolina. 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
$8,511
AK $9,550SC $1,698
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.