How much rates vary
Facilitymedian $1,148 · 10th to 90th $240 to $7,413Professionalmedian $661 · 10th to 90th $240 to $1,514
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 $239.88 Median $239.88 Typical High $14,454.40 | Facility | None | $239.88 | $239.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $2,089.30 | Professional | None | $239.88 | $239.88 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $5,888.44 Typical High $7,585.78 | Facility | None | $5,623.41 | $5,888.44 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $758.58 Typical High $1,584.89 | Professional | None | $208.93 | $758.58 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $131.83 Median $467.74 Typical High $954.99 | Professional | 62 · Two surgeons | $131.83 | $467.74 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $120.23 Typical High $245.47 | Professional | 80 · Assistant surgeon | $33.11 | $120.23 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $29.51 Median $107.15 Typical High $223.87 | Professional | AS · PA/NP assist | $29.51 | $107.15 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $537.03 Typical High $1,479.11 | Facility | None | $457.09 | $537.03 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $1,000.00 | Professional | None | $316.23 | $562.34 | $1,000.00 |
DeanCare Setting Facility Modifier None Typical Low $208.93 Median $7,943.28 Typical High $14,454.40 | Facility | None | $208.93 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $660.69 | Professional | None | $380.19 | $478.63 | $660.69 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $912.01 Typical High $1,778.28 | Facility | None | $199.53 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $676.08 Typical High $1,071.52 | Professional | None | $239.88 | $676.08 | $1,071.52 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $630.96 | Professional | None | $263.03 | $457.09 | $630.96 |
Prevea360 Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $416.87 | Facility | None | $165.96 | $229.09 | $416.87 |
Quartz Setting Professional Modifier None Typical Low $199.53 Median $426.58 Typical High $776.25 | Professional | None | $199.53 | $426.58 | $776.25 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $2,691.53 | Facility | None | $758.58 | $1,071.52 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Security Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Security Health Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,348.96 | Professional | None | $870.96 | $1,174.90 | $1,348.96 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $223.87 Median $676.08 Typical High $1,047.13 | Professional | None | $223.87 | $676.08 | $1,047.13 |
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 $120.23 Median $120.23 Typical High $1,047.13 | Professional | 52 · Reduced service | $120.23 | $120.23 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $416.87 | Professional | 53 · Discontinued | $47.86 | $47.86 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $1,548.82 | Professional | 54 · Surgery only | $181.97 | $181.97 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $309.03 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $208.93 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $208.93 |
Where Wisconsin sits
The same service costs 19.0 times more in Alabama than in Delaware. 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
AL $7,349DE $386
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.