How much rates vary
Facilitymedian $6,761 · 10th to 90th $912 to $16,982Professionalmedian $4,074 · 10th to 90th $1,514 to $9,333
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 $1,513.56 Median $1,513.56 Typical High $14,454.40 | Facility | None | $1,513.56 | $1,513.56 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $12,589.25 | Professional | None | $1,513.56 | $1,513.56 | $12,589.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,606.93 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $4,677.35 Typical High $9,772.37 | Professional | None | $1,318.26 | $4,677.35 | $9,772.37 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $7,079.46 Typical High $14,125.38 | Professional | 50 · Both sides | $1,949.84 | $7,079.46 | $14,125.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $2,951.21 Typical High $6,025.60 | Professional | 62 · Two surgeons | $831.76 | $2,951.21 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $741.31 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $208.93 | $741.31 | $1,513.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $660.69 Typical High $1,318.26 | Professional | AS · PA/NP assist | $181.97 | $660.69 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,884.03 Typical High $4,466.84 | Facility | None | $812.83 | $2,884.03 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $3,630.78 Typical High $6,309.57 | Professional | None | $1,949.84 | $3,630.78 | $6,309.57 |
DeanCare Setting Facility Modifier None Typical Low $1,318.26 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,318.26 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $4,073.80 | Professional | None | $2,398.83 | $2,951.21 | $4,073.80 |
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 $1,479.11 Median $4,168.69 Typical High $6,760.83 | Professional | None | $1,479.11 | $4,168.69 | $6,760.83 |
Network Health Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,511.89 | Facility | None | $1,698.24 | $2,089.30 | $2,511.89 |
Network Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,884.03 Typical High $3,981.07 | Professional | None | $1,659.59 | $2,884.03 | $3,981.07 |
Prevea360 Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,570.40 | Facility | None | $1,023.29 | $1,445.44 | $2,570.40 |
Quartz Setting Professional Modifier None Typical Low $1,230.27 Median $2,818.38 Typical High $5,248.07 | Professional | None | $1,230.27 | $2,818.38 | $5,248.07 |
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 $1,949.84 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,949.84 | $1,949.84 | $2,691.53 |
Security Health Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Security Health Setting Professional Modifier None Typical Low $5,495.41 Median $7,413.10 Typical High $8,317.64 | Professional | None | $5,495.41 | $7,413.10 | $8,317.64 |
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 $1,380.38 Median $4,168.69 Typical High $6,606.93 | Professional | None | $1,380.38 | $4,168.69 | $6,606.93 |
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 $758.58 Median $758.58 Typical High $6,165.95 | Professional | 52 · Reduced service | $758.58 | $758.58 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $2,511.89 | Professional | 53 · Discontinued | $302.00 | $302.00 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $9,332.54 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $9,332.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $1,862.09 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $1,862.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $1,258.93 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $1,258.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $8,709.64 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $8,709.64 |
Where Wisconsin sits
The same service costs 7.9 times more in Maine 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.
Physician feeFacility fee
ME $15,945AR $2,026
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.