How much rates vary
Facilitymedian $5,623 · 10th to 90th $813 to $16,218Professionalmedian $3,981 · 10th to 90th $1,862 to $16,982
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 $1,862.09 Median $1,862.09 Typical High $14,454.40 | Facility | None | $1,862.09 | $1,862.09 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $29,512.09 | Professional | None | $1,862.09 | $1,862.09 | $29,512.09 |
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 $2,511.89 Median $7,943.28 Typical High $15,488.17 | Professional | None | $2,511.89 | $7,943.28 | $15,488.17 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $5,011.87 Typical High $9,772.37 | Professional | 62 · Two surgeons | $1,584.89 | $5,011.87 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,623.41 Typical High $8,709.64 | Facility | None | $812.83 | $5,623.41 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $3,388.44 Typical High $7,943.28 | Professional | None | $3,235.94 | $3,388.44 | $7,943.28 |
DeanCare Setting Facility Modifier None Typical Low $2,570.40 Median $7,943.28 Typical High $14,791.08 | Facility | None | $2,570.40 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Professional | None | $6,165.95 | $6,165.95 | $6,165.95 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,570.40 Typical High $18,197.01 | Facility | None | $436.52 | $2,570.40 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,344.23 Median $7,244.36 Typical High $16,982.44 | Professional | None | $2,344.23 | $7,244.36 | $16,982.44 |
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 $8,128.31 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,128.31 | $8,912.51 | $8,912.51 |
Prevea360 Setting Facility Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $4,168.69 | Facility | None | $1,995.26 | $2,570.40 | $4,168.69 |
Quartz Setting Professional Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $6,309.57 | Professional | None | $1,778.28 | $3,548.13 | $6,309.57 |
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 $3,388.44 Median $3,388.44 Typical High $5,248.07 | Professional | None | $3,388.44 | $3,388.44 | $5,248.07 |
Security Health Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
Security Health Setting Professional Modifier None Typical Low $8,511.38 Median $10,964.78 Typical High $11,748.98 | Professional | None | $8,511.38 | $10,964.78 | $11,748.98 |
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 $1,995.26 Median $3,311.31 Typical High $9,120.11 | Professional | None | $1,995.26 | $3,311.31 | $9,120.11 |
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 $912.01 Median $912.01 Typical High $14,791.08 | Professional | 52 · Reduced service | $912.01 | $912.01 | $14,791.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $5,888.44 | Professional | 53 · Discontinued | $371.54 | $371.54 | $5,888.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $21,877.62 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $21,877.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $4,365.16 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $4,365.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $2,951.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $2,951.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $20,417.38 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $20,417.38 |
Where Wisconsin sits
The same service costs 18.2 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· 4th of 51
$4,266
AK $10,233NY $562
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.