How much rates vary
Facilitymedian $6,607 · 10th to 90th $813 to $17,783Professionalmedian $4,898 · 10th to 90th $1,549 to $11,220
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 $1,548.82 Median $1,548.82 Typical High $14,454.40 | Facility | None | $1,548.82 | $1,548.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $16,218.10 | Professional | None | $1,548.82 | $1,548.82 | $16,218.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,715.19 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,715.19 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $5,495.41 Typical High $11,481.54 | Professional | None | $1,862.09 | $5,495.41 | $11,481.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $891.25 Typical High $1,819.70 | Professional | 80 · Assistant surgeon | $302.00 | $891.25 | $1,819.70 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $776.25 Typical High $1,621.81 | Professional | AS · PA/NP assist | $263.03 | $776.25 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,890.45 Typical High $6,025.60 | Facility | None | $812.83 | $3,890.45 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $5,495.41 | Professional | None | $2,041.74 | $3,162.28 | $5,495.41 |
DeanCare Setting Facility Modifier None Typical Low $1,659.59 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,691.53 Median $3,981.07 Typical High $5,248.07 | Professional | None | $2,691.53 | $3,981.07 | $5,248.07 |
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 $1,698.24 Median $4,365.16 Typical High $10,000.00 | Professional | None | $1,698.24 | $4,365.16 | $10,000.00 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,884.03 | Facility | None | $2,089.30 | $2,238.72 | $2,884.03 |
Network Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,801.89 Typical High $5,011.87 | Professional | None | $2,187.76 | $3,801.89 | $5,011.87 |
Prevea360 Setting Facility Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $3,235.94 | Facility | None | $1,380.38 | $1,737.80 | $3,235.94 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $3,715.35 Typical High $6,456.54 | Professional | None | $1,621.81 | $3,715.35 | $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 $2,041.74 Median $2,041.74 Typical High $4,786.30 | Professional | None | $2,041.74 | $2,041.74 | $4,786.30 |
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 $7,079.46 Median $8,912.51 Typical High $11,748.98 | Professional | None | $7,079.46 | $8,912.51 | $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 $1,479.11 Median $4,168.69 Typical High $7,585.78 | Professional | None | $1,479.11 | $4,168.69 | $7,585.78 |
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 $776.25 Median $776.25 Typical High $8,128.31 | Professional | 52 · Reduced service | $776.25 | $776.25 | $8,128.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $3,235.94 | Professional | 53 · Discontinued | $316.23 | $316.23 | $3,235.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $12,022.64 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $12,022.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $2,454.71 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $2,454.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $1,621.81 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $1,621.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $11,220.18 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $11,220.18 |
Where Wisconsin sits
The same service costs 5.6 times more in Alaska than in Texas. 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
$5,012
AK $6,310TX $1,122
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.