How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,202 to $14,454Professionalmedian $3,236 · 10th to 90th $1,202 to $6,457
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 $6,606.93 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,606.93 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $3,801.89 Typical High $6,606.93 | Professional | None | $1,318.26 | $3,801.89 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $2,398.83 Typical High $4,073.80 | Professional | 62 · Two surgeons | $831.76 | $2,398.83 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $602.56 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $208.93 | $602.56 | $1,047.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $524.81 Typical High $912.01 | Professional | AS · PA/NP assist | $186.21 | $524.81 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,754.23 Typical High $4,168.69 | Facility | None | $812.83 | $2,754.23 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $3,890.45 | Professional | None | $1,445.44 | $2,187.76 | $3,890.45 |
DeanCare Setting Facility Modifier None Typical Low $1,148.15 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,148.15 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,754.23 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $4,073.80 Typical High $10,964.78 | Facility | None | $1,148.15 | $4,073.80 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $3,090.30 Typical High $5,011.87 | Professional | None | $1,230.27 | $3,090.30 | $5,011.87 |
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 $1,548.82 Median $2,630.27 Typical High $3,311.31 | Professional | None | $1,548.82 | $2,630.27 | $3,311.31 |
Prevea360 Setting Facility Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,089.30 | Facility | None | $954.99 | $1,230.27 | $2,089.30 |
Quartz Setting Professional Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $4,570.88 | Professional | None | $1,047.13 | $2,398.83 | $4,570.88 |
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 $1,584.89 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,584.89 | $1,584.89 | $3,090.30 |
Security Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Security Health Setting Professional Modifier None Typical Low $2,754.23 Median $5,370.32 Typical High $6,025.60 | Professional | None | $2,754.23 | $5,370.32 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,309.57 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,309.57 | $11,481.54 |
United Setting Professional Modifier None Typical Low $977.24 Median $2,818.38 Typical High $4,786.30 | Professional | None | $977.24 | $2,818.38 | $4,786.30 |
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 $9,332.54 | Professional | 54 · Surgery only | $891.25 | $891.25 | $9,332.54 |
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 $8,709.64 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $8,709.64 |
Where Wisconsin sits
The same service costs 9.8 times more in Maine than in Arkansas. 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.
Physician feeFacility fee
ME $23,866AR $2,433
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.