How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,175 to $11,220Professionalmedian $2,344 · 10th to 90th $851 to $4,074
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 $851.14 Median $851.14 Typical High $14,454.40 | Facility | None | $851.14 | $851.14 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $6,165.95 | Professional | None | $851.14 | $851.14 | $6,165.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $2,570.40 Typical High $4,570.88 | Professional | None | $891.25 | $2,570.40 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $3,801.89 Typical High $6,760.83 | Professional | 50 · Both sides | $1,380.38 | $3,801.89 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $407.38 Typical High $724.44 | Professional | 80 · Assistant surgeon | $144.54 | $407.38 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $354.81 Typical High $630.96 | Professional | AS · PA/NP assist | $128.82 | $354.81 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,570.40 Typical High $4,365.16 | Facility | None | $1,023.29 | $2,570.40 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,000.00 | $1,548.82 | $2,691.53 |
DeanCare Setting Facility Modifier None Typical Low $812.83 Median $7,943.28 Typical High $14,454.40 | Facility | None | $812.83 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,949.84 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $4,570.88 Typical High $10,964.78 | Facility | None | $912.01 | $4,570.88 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $2,344.23 Typical High $3,890.45 | Professional | None | $851.14 | $2,344.23 | $3,890.45 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,862.09 | $2,454.71 |
Prevea360 Setting Facility Modifier None Typical Low $676.08 Median $870.96 Typical High $1,513.56 | Facility | None | $676.08 | $870.96 | $1,513.56 |
Quartz Setting Professional Modifier None Typical Low $741.31 Median $1,698.24 Typical High $3,162.28 | Professional | None | $741.31 | $1,698.24 | $3,162.28 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,884.03 Typical High $4,786.30 | Facility | None | $812.83 | $2,884.03 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,023.29 | $2,344.23 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Security Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,388.44 Typical High $3,801.89 | Professional | None | $2,238.72 | $3,388.44 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $707.95 Median $2,089.30 Typical High $3,801.89 | Professional | None | $707.95 | $2,089.30 | $3,801.89 |
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 $426.58 Median $426.58 Typical High $3,090.30 | Professional | 52 · Reduced service | $426.58 | $426.58 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $1,230.27 | Professional | 53 · Discontinued | $169.82 | $169.82 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $4,570.88 | Professional | 54 · Surgery only | $630.96 | $630.96 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $912.01 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $616.60 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $4,265.80 |
Where Wisconsin sits
The same service costs 5.8 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
$2,754
AK $3,020UT $525
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.