How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $16,218Professionalmedian $4,677 · 10th to 90th $1,698 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 $1,698.24 Median $1,698.24 Typical High $14,454.40 | Facility | None | $1,698.24 | $1,698.24 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $12,302.69 | Professional | None | $1,698.24 | $1,698.24 | $12,302.69 |
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 $1,862.09 Median $5,128.61 Typical High $9,549.93 | Professional | None | $1,862.09 | $5,128.61 | $9,549.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $831.76 Typical High $1,548.82 | Professional | 80 · Assistant surgeon | $295.12 | $831.76 | $1,548.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $724.44 Typical High $1,348.96 | Professional | AS · PA/NP assist | $257.04 | $724.44 | $1,348.96 |
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 $3,090.30 Typical High $5,495.41 | Professional | None | $2,041.74 | $3,090.30 | $5,495.41 |
DeanCare Setting Facility Modifier None Typical Low $1,621.81 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,621.81 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,691.53 Median $3,981.07 Typical High $5,011.87 | Professional | None | $2,691.53 | $3,981.07 | $5,011.87 |
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 $1,778.28 Median $4,786.30 Typical High $7,943.28 | Professional | None | $1,778.28 | $4,786.30 | $7,943.28 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $2,951.21 | Facility | None | $2,089.30 | $2,187.76 | $2,951.21 |
Network Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,801.89 Typical High $4,897.79 | Professional | None | $2,187.76 | $3,801.89 | $4,897.79 |
Prevea360 Setting Facility Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $3,090.30 | Facility | None | $1,380.38 | $1,737.80 | $3,090.30 |
Quartz Setting Professional Modifier None Typical Low $1,479.11 Median $3,388.44 Typical High $6,456.54 | Professional | None | $1,479.11 | $3,388.44 | $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 $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
Security Health Setting Professional Modifier None Typical Low $4,466.84 Median $6,760.83 Typical High $7,762.47 | Professional | None | $4,466.84 | $6,760.83 | $7,762.47 |
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 $4,265.80 Typical High $7,762.47 | Professional | None | $1,479.11 | $4,265.80 | $7,762.47 |
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 $851.14 Median $851.14 Typical High $6,165.95 | Professional | 52 · Reduced service | $851.14 | $851.14 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $2,454.71 | Professional | 53 · Discontinued | $338.84 | $338.84 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $9,120.11 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $1,819.70 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $1,819.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $8,511.38 |
Where Wisconsin sits
The same service costs 6.0 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
$4,786
AK $6,026TX $1,000
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.