How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,479 to $14,454Professionalmedian $2,399 · 10th to 90th $676 to $8,710
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 $512.86 Median $1,819.70 Typical High $14,454.40 | Facility | None | $512.86 | $1,819.70 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $1,819.70 Typical High $11,220.18 | Professional | None | $512.86 | $1,819.70 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $2,691.53 Typical High $9,332.54 | Professional | None | $1,023.29 | $2,691.53 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $1,698.24 Typical High $5,888.44 | Professional | 62 · Two surgeons | $645.65 | $1,698.24 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,187.76 | $4,897.79 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $2,238.72 Typical High $6,025.60 | Professional | None | $676.08 | $2,238.72 | $6,025.60 |
DeanCare Setting Facility Modifier None Typical Low $524.81 Median $5,011.87 Typical High $9,332.54 | Facility | None | $524.81 | $5,011.87 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $6,025.60 | Professional | None | $954.99 | $1,380.38 | $6,025.60 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $5,754.40 Typical High $15,848.93 | Facility | None | $954.99 | $5,754.40 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $2,041.74 Median $5,495.41 Typical High $8,511.38 | Professional | None | $2,041.74 | $5,495.41 | $8,511.38 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $977.24 Median $2,570.40 Typical High $5,248.07 | Professional | None | $977.24 | $2,570.40 | $5,248.07 |
Prevea360 Setting Facility Modifier None Typical Low $489.78 Median $912.01 Typical High $3,311.31 | Facility | None | $489.78 | $912.01 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $1,949.84 Typical High $6,606.93 | Professional | None | $891.25 | $1,949.84 | $6,606.93 |
Quartz Setting Facility Modifier None Typical Low $1,995.26 Median $5,248.07 Typical High $7,943.28 | Facility | None | $1,995.26 | $5,248.07 | $7,943.28 |
Quartz Setting Professional Modifier None Typical Low $676.08 Median $1,318.26 Typical High $3,388.44 | Professional | None | $676.08 | $1,318.26 | $3,388.44 |
Security Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $4,365.16 | Professional | None | $1,122.02 | $1,122.02 | $4,365.16 |
Security Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,818.38 Typical High $10,000.00 | Professional | None | $1,659.59 | $2,818.38 | $10,000.00 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $588.84 Median $1,949.84 Typical High $7,762.47 | Professional | None | $588.84 | $1,949.84 | $7,762.47 |
8 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 Facility Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $1,348.96 | Facility | 54 · Surgery only | $389.05 | $389.05 | $1,348.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $269.15 | Facility | 55 · Aftercare only | $77.62 | $77.62 | $269.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $181.97 | Facility | 56 · Pre-op care only | $51.29 | $51.29 | $181.97 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $1,258.93 | Facility | 78 · Unplanned return to OR | $363.08 | $363.08 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $1,348.96 Typical High $8,317.64 | Professional | 54 · Surgery only | $389.05 | $1,348.96 | $8,317.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $269.15 Typical High $1,659.59 | Professional | 55 · Aftercare only | $77.62 | $269.15 | $1,659.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $181.97 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $51.29 | $181.97 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $1,258.93 Typical High $7,762.47 | Professional | 78 · Unplanned return to OR | $363.08 | $1,258.93 | $7,762.47 |
Where Wisconsin sits
The same service costs 4.5 times more in Alaska than in Nebraska. 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
$3,236
AK $3,981NE $891
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.