How much rates vary
Facilitymedian $7,943 · 10th to 90th $617 to $18,197Professionalmedian $1,549 · 10th to 90th $490 to $3,548
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 $446.68 Median $446.68 Typical High $14,454.40 | Facility | None | $446.68 | $446.68 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $4,677.35 | Professional | None | $446.68 | $446.68 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $12,302.69 Typical High $20,417.38 | Facility | None | $9,120.11 | $12,302.69 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $1,778.28 Typical High $3,801.89 | Professional | None | $575.44 | $1,778.28 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $1,122.02 Typical High $2,398.83 | Professional | 62 · Two surgeons | $363.08 | $1,122.02 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $281.84 Typical High $616.60 | Professional | 80 · Assistant surgeon | $93.33 | $281.84 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $245.47 Typical High $537.03 | Professional | AS · PA/NP assist | $81.28 | $245.47 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,445.44 Typical High $2,630.27 | Facility | None | $812.83 | $1,445.44 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,737.80 | Professional | None | $776.25 | $1,071.52 | $1,737.80 |
DeanCare Setting Facility Modifier None Typical Low $537.03 Median $7,943.28 Typical High $14,454.40 | Facility | None | $537.03 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,621.81 | Professional | None | $870.96 | $1,288.25 | $1,621.81 |
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 $562.34 Median $1,348.96 Typical High $2,754.23 | Professional | None | $562.34 | $1,348.96 | $2,754.23 |
Network Health Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,089.30 | Facility | None | $707.95 | $1,000.00 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $707.95 Median $1,230.27 Typical High $1,659.59 | Professional | None | $707.95 | $1,230.27 | $1,659.59 |
Prevea360 Setting Facility Modifier None Typical Low $436.52 Median $537.03 Typical High $1,023.29 | Facility | None | $436.52 | $537.03 | $1,023.29 |
Quartz Setting Professional Modifier None Typical Low $549.54 Median $1,258.93 Typical High $2,089.30 | Professional | None | $549.54 | $1,258.93 | $2,089.30 |
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 $851.14 Median $851.14 Typical High $1,584.89 | Professional | None | $851.14 | $851.14 | $1,584.89 |
Security Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Security Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $3,467.37 | Professional | None | $2,290.87 | $3,090.30 | $3,467.37 |
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 $489.78 Median $1,230.27 Typical High $2,511.89 | Professional | None | $489.78 | $1,230.27 | $2,511.89 |
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 $223.87 Median $223.87 Typical High $2,344.23 | Professional | 52 · Reduced service | $223.87 | $223.87 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $933.25 | Professional | 53 · Discontinued | $89.13 | $89.13 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $3,467.37 | Professional | 54 · Surgery only | $338.84 | $338.84 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $707.95 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $467.74 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $3,235.94 |
Where Wisconsin sits
The same service costs 24.5 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 $26,995AR $1,102
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.