How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,072 to $13,490Professionalmedian $2,692 · 10th to 90th $1,000 to $5,012
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 $1,000.00 Median $1,905.46 Typical High $14,454.40 | Facility | None | $1,000.00 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $7,244.36 | Professional | None | $1,000.00 | $1,000.00 | $7,244.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $9,332.54 Typical High $16,982.44 | Facility | None | $5,754.40 | $9,332.54 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $3,019.95 Typical High $5,623.41 | Professional | None | $1,071.52 | $3,019.95 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $1,905.46 Typical High $3,467.37 | Professional | 62 · Two surgeons | $676.08 | $1,905.46 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,019.95 Typical High $6,918.31 | Facility | None | $1,023.29 | $3,019.95 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,174.90 | $1,819.70 | $3,162.28 |
DeanCare Setting Facility Modifier None Typical Low $954.99 Median $7,943.28 Typical High $14,454.40 | Facility | None | $954.99 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $2,884.03 | Professional | None | $1,548.82 | $2,290.87 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,388.44 Typical High $8,709.64 | Facility | None | $933.25 | $3,388.44 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $2,818.38 Typical High $4,570.88 | Professional | None | $1,023.29 | $2,818.38 | $4,570.88 |
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 $1,258.93 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,258.93 | $2,187.76 | $2,884.03 |
Prevea360 Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $1,778.28 | Facility | None | $794.33 | $954.99 | $1,778.28 |
Quartz Setting Professional Modifier None Typical Low $870.96 Median $1,995.26 Typical High $3,715.35 | Professional | None | $870.96 | $1,995.26 | $3,715.35 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $4,570.88 Typical High $7,585.78 | Facility | None | $812.83 | $4,570.88 | $7,585.78 |
Quartz Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,174.90 | $2,818.38 |
Security Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Security Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,981.07 Typical High $4,466.84 | Professional | None | $2,630.27 | $3,981.07 | $4,466.84 |
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 $851.14 Median $2,454.71 Typical High $4,466.84 | Professional | None | $851.14 | $2,454.71 | $4,466.84 |
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 $501.19 Median $501.19 Typical High $3,630.78 | Professional | 52 · Reduced service | $501.19 | $501.19 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $1,445.44 | Professional | 53 · Discontinued | $199.53 | $199.53 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $5,370.32 | Professional | 54 · Surgery only | $741.31 | $741.31 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $1,071.52 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $724.44 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $5,011.87 |
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
$3,162
AK $3,548UT $617
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.