How much rates vary
Facilitymedian $6,761 · 10th to 90th $759 to $17,783Professionalmedian $3,467 · 10th to 90th $1,259 to $10,000
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 $3,467.37 Median $3,467.37 Typical High $14,454.40 | Facility | None | $3,467.37 | $3,467.37 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $10,000.00 | Professional | None | $3,467.37 | $3,467.37 | $10,000.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,737.80 Median $1,737.80 Typical High $5,011.87 | Professional | 52 · Reduced service | $1,737.80 | $1,737.80 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $691.83 Typical High $2,041.74 | Professional | 53 · Discontinued | $691.83 | $691.83 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,570.40 Typical High $7,585.78 | Professional | 54 · Surgery only | $2,570.40 | $2,570.40 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $1,513.56 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $346.74 Typical High $1,000.00 | Professional | 56 · Pre-op care only | $346.74 | $346.74 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,471.29 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,471.29 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,258.93 | Professional | None | $741.31 | $1,122.02 | $1,258.93 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $724.44 Typical High $1,122.02 | Professional | None | $363.08 | $724.44 | $1,122.02 |
DeanCare Setting Facility Modifier None Typical Low $6,165.95 Median $8,128.31 Typical High $14,791.08 | Facility | None | $6,165.95 | $8,128.31 | $14,791.08 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $2,454.71 Typical High $18,197.01 | Facility | None | $426.58 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
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 |
Prevea360 Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $363.08 Median $630.96 Typical High $812.83 | Professional | None | $363.08 | $630.96 | $812.83 |
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 $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
2 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $177.83 Typical High $199.53 | Professional | 80 · Assistant surgeon | $117.49 | $177.83 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $158.49 Typical High $173.78 | Professional | AS · PA/NP assist | $104.71 | $158.49 | $173.78 |
Where Wisconsin sits
The same service costs 117.5 times more in Nebraska than in Hawaii. 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· 5th of 51
$3,467
NE $3,467HI $29.51
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.