How much rates vary
Facilitymedian $3,311 · 10th to 90th $851 to $7,762Professionalmedian $1,318 · 10th to 90th $490 to $2,344
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 $489.78 Median $1,905.46 Typical High $14,454.40 | Facility | None | $489.78 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $3,548.13 | Professional | None | $489.78 | $489.78 | $3,548.13 |
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 $524.81 Median $1,445.44 Typical High $2,570.40 | Professional | None | $524.81 | $1,445.44 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $2,137.96 Typical High $3,890.45 | Professional | 50 · Both sides | $776.25 | $2,137.96 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $229.09 Typical High $407.38 | Professional | 80 · Assistant surgeon | $83.18 | $229.09 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $199.53 Typical High $363.08 | Professional | AS · PA/NP assist | $72.44 | $199.53 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,479.11 Typical High $2,511.89 | Facility | None | $707.95 | $1,479.11 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,548.82 | Professional | None | $575.44 | $933.25 | $1,548.82 |
DeanCare Setting Facility Modifier None Typical Low $467.74 Median $2,818.38 Typical High $5,128.61 | Facility | None | $467.74 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,380.38 | Professional | None | $758.58 | $1,122.02 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $3,162.28 Typical High $8,317.64 | Facility | None | $691.83 | $3,162.28 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,318.26 Typical High $2,238.72 | Professional | None | $489.78 | $1,318.26 | $2,238.72 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $616.60 Median $1,071.52 Typical High $1,380.38 | Professional | None | $616.60 | $1,071.52 | $1,380.38 |
Prevea360 Setting Facility Modifier None Typical Low $389.05 Median $501.19 Typical High $851.14 | Facility | None | $389.05 | $501.19 | $851.14 |
Quartz Setting Professional Modifier None Typical Low $436.52 Median $1,000.00 Typical High $1,819.70 | Professional | None | $436.52 | $1,000.00 | $1,819.70 |
Quartz Setting Facility Modifier None Typical Low $537.03 Median $1,659.59 Typical High $2,754.23 | Facility | None | $537.03 | $1,659.59 | $2,754.23 |
Quartz Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,348.96 | Professional | None | $575.44 | $575.44 | $1,348.96 |
Security Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Security Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,905.46 | $2,187.76 |
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 $407.38 Median $1,148.15 Typical High $2,137.96 | Professional | None | $407.38 | $1,148.15 | $2,137.96 |
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 $245.47 Median $245.47 Typical High $1,778.28 | Professional | 52 · Reduced service | $245.47 | $245.47 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $707.95 | Professional | 53 · Discontinued | $97.72 | $97.72 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $2,630.27 | Professional | 54 · Surgery only | $363.08 | $363.08 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $524.81 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $354.81 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $2,454.71 |
Where Wisconsin sits
The same service costs 5.1 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
$1,585
AK $1,698UT $331
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.