How much rates vary
Facilitymedian $5,754 · 10th to 90th $813 to $16,218Professionalmedian $4,365 · 10th to 90th $2,138 to $15,136
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 $2,137.96 Median $2,137.96 Typical High $14,454.40 | Facility | None | $2,137.96 | $2,137.96 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $19,952.62 | Professional | None | $2,137.96 | $2,137.96 | $19,952.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,748.98 | Facility | None | $5,011.87 | $8,317.64 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $6,760.83 Typical High $16,218.10 | Professional | None | $2,041.74 | $6,760.83 | $16,218.10 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $4,265.80 Typical High $10,232.93 | Professional | 62 · Two surgeons | $1,288.25 | $4,265.80 | $10,232.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $1,071.52 Typical High $2,570.40 | Professional | 80 · Assistant surgeon | $323.59 | $1,071.52 | $2,570.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $954.99 Typical High $2,238.72 | Professional | AS · PA/NP assist | $288.40 | $954.99 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $6,309.57 Typical High $9,772.37 | Facility | None | $812.83 | $6,309.57 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $3,801.89 Typical High $8,912.51 | Professional | None | $3,388.44 | $3,801.89 | $8,912.51 |
DeanCare Setting Facility Modifier None Typical Low $2,691.53 Median $7,943.28 Typical High $14,791.08 | Facility | None | $2,691.53 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,691.53 Typical High $18,197.01 | Facility | None | $436.52 | $2,691.53 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,511.89 Median $8,128.31 Typical High $15,135.61 | Professional | None | $2,511.89 | $8,128.31 | $15,135.61 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,079.46 | $7,943.28 | $7,943.28 |
Prevea360 Setting Facility Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $4,897.79 | Facility | None | $2,238.72 | $2,691.53 | $4,897.79 |
Quartz Setting Professional Modifier None Typical Low $2,089.30 Median $4,168.69 Typical High $6,456.54 | Professional | None | $2,089.30 | $4,168.69 | $6,456.54 |
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 $3,801.89 Median $3,801.89 Typical High $4,466.84 | Professional | None | $3,801.89 | $3,801.89 | $4,466.84 |
Security Health Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
Security Health Setting Professional Modifier None Typical Low $9,549.93 Median $12,302.69 Typical High $13,489.63 | Professional | None | $9,549.93 | $12,302.69 | $13,489.63 |
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 $2,187.76 Median $3,630.78 Typical High $10,471.29 | Professional | None | $2,187.76 | $3,630.78 | $10,471.29 |
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 $1,071.52 Median $1,071.52 Typical High $10,000.00 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $10,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $3,981.07 | Professional | 53 · Discontinued | $426.58 | $426.58 | $3,981.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $14,791.08 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $14,791.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $3,019.95 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $3,019.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $1,995.26 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $1,995.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $13,803.84 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $13,803.84 |
Where Wisconsin sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 7th of 51
$4,365
AK $8,511KY $871
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.