How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,000 to $11,220Professionalmedian $1,413 · 10th to 90th $513 to $2,884
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 $537.03 Median $3,090.30 Typical High $14,454.40 | Facility | None | $537.03 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $5,128.61 | Professional | None | $537.03 | $537.03 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $1,584.89 Typical High $3,019.95 | Professional | None | $457.09 | $1,584.89 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $251.19 Typical High $478.63 | Professional | 80 · Assistant surgeon | $74.13 | $251.19 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $218.78 Typical High $416.87 | Professional | AS · PA/NP assist | $64.57 | $218.78 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,778.28 Typical High $7,413.10 | Facility | None | $933.25 | $1,778.28 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,258.93 Typical High $2,238.72 | Professional | None | $691.83 | $1,258.93 | $2,238.72 |
DeanCare Setting Facility Modifier None Typical Low $501.19 Median $3,162.28 Typical High $5,888.44 | Facility | None | $501.19 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,318.26 | Professional | None | $870.96 | $1,071.52 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $5,623.41 Typical High $13,182.57 | Facility | None | $812.83 | $5,623.41 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,380.38 Typical High $2,238.72 | Professional | None | $478.63 | $1,380.38 | $2,238.72 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,288.25 | Professional | None | $588.84 | $891.25 | $1,288.25 |
Prevea360 Setting Facility Modifier None Typical Low $436.52 Median $501.19 Typical High $812.83 | Facility | None | $436.52 | $501.19 | $812.83 |
Quartz Setting Professional Modifier None Typical Low $457.09 Median $1,047.13 Typical High $1,737.80 | Professional | None | $457.09 | $1,047.13 | $1,737.80 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $4,897.79 Typical High $8,128.31 | Facility | None | $724.44 | $4,897.79 | $8,128.31 |
Quartz Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $812.83 | Professional | None | $691.83 | $691.83 | $812.83 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Security Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $2,884.03 | Professional | None | $1,584.89 | $2,511.89 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $457.09 Median $1,380.38 Typical High $2,137.96 | Professional | None | $457.09 | $1,380.38 | $2,137.96 |
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 $269.15 Median $269.15 Typical High $2,511.89 | Professional | 52 · Reduced service | $269.15 | $269.15 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $1,023.29 | Professional | 53 · Discontinued | $107.15 | $107.15 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $3,801.89 | Professional | 54 · Surgery only | $398.11 | $398.11 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $758.58 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $512.86 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $3,548.13 |
Where Wisconsin sits
The same service costs 5.4 times more in Alaska than in New York. 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
$1,862
AK $2,239NY $417
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.