How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,072 to $7,943Professionalmedian $3,236 · 10th to 90th $1,047 to $7,586
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 $1,047.13 Median $3,090.30 Typical High $14,454.40 | Facility | None | $1,047.13 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $11,220.18 | Professional | None | $1,047.13 | $1,047.13 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $3,801.89 Typical High $7,943.28 | Professional | None | $1,258.93 | $3,801.89 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $2,398.83 Typical High $5,011.87 | Professional | 62 · Two surgeons | $794.33 | $2,398.83 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,511.89 Typical High $3,090.30 | Facility | None | $1,023.29 | $2,511.89 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $3,630.78 | Professional | None | $1,380.38 | $2,137.96 | $3,630.78 |
DeanCare Setting Facility Modifier None Typical Low $1,122.02 Median $3,162.28 Typical High $5,888.44 | Facility | None | $1,122.02 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $3,311.31 | Professional | None | $1,819.70 | $2,691.53 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $8,317.64 | Facility | None | $933.25 | $3,162.28 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $3,162.28 Typical High $6,760.83 | Professional | None | $1,174.90 | $3,162.28 | $6,760.83 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,862.09 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,570.40 Typical High $3,311.31 | Professional | None | $1,479.11 | $2,570.40 | $3,311.31 |
Prevea360 Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $2,041.74 | Facility | None | $812.83 | $1,122.02 | $2,041.74 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $2,344.23 Typical High $4,365.16 | Professional | None | $1,023.29 | $2,344.23 | $4,365.16 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $1,819.70 Typical High $2,884.03 | Facility | None | $812.83 | $1,819.70 | $2,884.03 |
Quartz Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $3,235.94 | Professional | None | $1,380.38 | $1,380.38 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $6,025.60 Typical High $7,762.47 | Professional | None | $4,677.35 | $6,025.60 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $954.99 Median $2,818.38 Typical High $5,128.61 | Professional | None | $954.99 | $2,818.38 | $5,128.61 |
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 $524.81 Median $524.81 Typical High $5,623.41 | Professional | 52 · Reduced service | $524.81 | $524.81 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $2,238.72 | Professional | 53 · Discontinued | $208.93 | $208.93 | $2,238.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $8,317.64 | Professional | 54 · Surgery only | $794.33 | $794.33 | $8,317.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $1,659.59 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $1,659.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $7,762.47 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $7,762.47 |
Where Wisconsin sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 2nd of 51
$3,236
AK $4,074UT $692
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.