How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $16,218Professionalmedian $3,631 · 10th to 90th $1,202 to $8,511
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 $1,202.26 Median $1,202.26 Typical High $14,454.40 | Facility | None | $1,202.26 | $1,202.26 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $12,589.25 | Professional | None | $1,202.26 | $1,202.26 | $12,589.25 |
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 $1,412.54 Median $4,365.16 Typical High $9,120.11 | Professional | None | $1,412.54 | $4,365.16 | $9,120.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $6,456.54 Typical High $13,489.63 | Professional | 50 · Both sides | $2,137.96 | $6,456.54 | $13,489.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $691.83 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $223.87 | $691.83 | $1,445.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $602.56 Typical High $1,258.93 | Professional | AS · PA/NP assist | $199.53 | $602.56 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,951.21 Typical High $4,570.88 | Facility | None | $812.83 | $2,951.21 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,398.83 Typical High $4,168.69 | Professional | None | $1,548.82 | $2,398.83 | $4,168.69 |
DeanCare Setting Facility Modifier None Typical Low $1,258.93 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,258.93 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $3,801.89 | Professional | None | $2,041.74 | $3,019.95 | $3,801.89 |
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 $1,348.96 Median $3,630.78 Typical High $7,762.47 | Professional | None | $1,348.96 | $3,630.78 | $7,762.47 |
Network Health Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,238.72 | Facility | None | $1,698.24 | $2,089.30 | $2,238.72 |
Network Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,884.03 Typical High $3,801.89 | Professional | None | $1,659.59 | $2,884.03 | $3,801.89 |
Prevea360 Setting Facility Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,344.23 | Facility | None | $1,047.13 | $1,348.96 | $2,344.23 |
Quartz Setting Professional Modifier None Typical Low $1,148.15 Median $2,630.27 Typical High $4,897.79 | Professional | None | $1,148.15 | $2,630.27 | $4,897.79 |
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 $1,548.82 Median $1,548.82 Typical High $3,630.78 | Professional | None | $1,548.82 | $1,548.82 | $3,630.78 |
Security Health Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Security Health Setting Professional Modifier None Typical Low $5,495.41 Median $6,760.83 Typical High $8,912.51 | Professional | None | $5,495.41 | $6,760.83 | $8,912.51 |
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 $1,122.02 Median $3,235.94 Typical High $5,754.40 | Professional | None | $1,122.02 | $3,235.94 | $5,754.40 |
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 $602.56 Median $602.56 Typical High $6,309.57 | Professional | 52 · Reduced service | $602.56 | $602.56 | $6,309.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $2,511.89 | Professional | 53 · Discontinued | $239.88 | $239.88 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $9,549.93 | Professional | 54 · Surgery only | $891.25 | $891.25 | $9,549.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $1,905.46 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $1,905.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $1,258.93 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $1,258.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $8,912.51 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $8,912.51 |
Where Wisconsin sits
The same service costs 5.9 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
$3,890
AK $4,677TX $794
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.