How much rates vary
Facilitymedian $3,311 · 10th to 90th $372 to $6,166Professionalmedian $427 · 10th to 90th $120 to $912
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 $120.23 Median $1,905.46 Typical High $14,454.40 | Facility | None | $120.23 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $1,698.24 | Professional | None | $120.23 | $120.23 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $467.74 Typical High $912.01 | Professional | None | $128.82 | $467.74 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.91 Median $75.86 Typical High $144.54 | Professional | 80 · Assistant surgeon | $22.91 | $75.86 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $66.07 Typical High $128.82 | Professional | AS · PA/NP assist | $17.78 | $66.07 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $371.54 Typical High $562.34 | Facility | None | $331.13 | $371.54 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $446.68 | Professional | None | $275.42 | $398.11 | $446.68 |
DeanCare Setting Facility Modifier None Typical Low $147.91 Median $2,818.38 Typical High $5,370.32 | Facility | None | $147.91 | $2,818.38 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $3,630.78 Typical High $6,165.95 | Facility | None | $239.88 | $3,630.78 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $389.05 Typical High $602.56 | Professional | None | $154.88 | $389.05 | $602.56 |
Network Health Setting Facility Modifier None Typical Low $2,818.38 Median $3,890.45 Typical High $4,786.30 | Facility | None | $2,818.38 | $3,890.45 | $4,786.30 |
Prevea360 Setting Facility Modifier None Typical Low $114.82 Median $147.91 Typical High $251.19 | Facility | None | $114.82 | $147.91 | $251.19 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $245.47 Typical High $537.03 | Professional | None | $112.20 | $245.47 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $954.99 | Professional | None | $676.08 | $691.83 | $954.99 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $3,981.07 Typical High $6,025.60 | Facility | None | $3,090.30 | $3,981.07 | $6,025.60 |
United Setting Professional Modifier None Typical Low $125.89 Median $363.08 Typical High $602.56 | Professional | None | $125.89 | $363.08 | $602.56 |
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 $58.88 Median $58.88 Typical High $851.14 | Professional | 52 · Reduced service | $58.88 | $58.88 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $338.84 | Professional | 53 · Discontinued | $23.99 | $23.99 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $1,258.93 | Professional | 54 · Surgery only | $89.13 | $89.13 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $251.19 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $169.82 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $169.82 |
Where Wisconsin sits
The same service costs 37.2 times more in Oklahoma 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· 14th of 51
$603
OK $4,266NY $115
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.