How much rates vary
Facilitymedian $3,236 · 10th to 90th $676 to $13,804Professionalmedian $1,023 · 10th to 90th $380 to $2,042
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 $380.19 Median $3,090.30 Typical High $14,454.40 | Facility | None | $380.19 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $3,388.44 | Professional | None | $354.81 | $380.19 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $9,772.37 Typical High $16,982.44 | Facility | None | $2,041.74 | $9,772.37 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $1,174.90 Typical High $2,089.30 | Professional | None | $416.87 | $1,174.90 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $186.21 Typical High $331.13 | Professional | 80 · Assistant surgeon | $66.07 | $186.21 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $165.96 Typical High $288.40 | Professional | AS · PA/NP assist | $58.88 | $165.96 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $977.24 Typical High $1,778.28 | Facility | None | $776.25 | $977.24 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $1,230.27 | Professional | None | $467.74 | $724.44 | $1,230.27 |
DeanCare Setting Facility Modifier None Typical Low $363.08 Median $4,365.16 Typical High $7,762.47 | Facility | None | $363.08 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,047.13 | Professional | None | $588.84 | $891.25 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $4,786.30 | Facility | None | $588.84 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $954.99 Typical High $1,584.89 | Professional | None | $380.19 | $954.99 | $1,584.89 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $489.78 Median $831.76 Typical High $1,023.29 | Professional | None | $489.78 | $831.76 | $1,023.29 |
Prevea360 Setting Facility Modifier None Typical Low $302.00 Median $389.05 Typical High $676.08 | Facility | None | $302.00 | $389.05 | $676.08 |
Quartz Setting Professional Modifier None Typical Low $338.84 Median $776.25 Typical High $1,445.44 | Professional | None | $338.84 | $776.25 | $1,445.44 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,174.90 Typical High $3,630.78 | Facility | None | $758.58 | $1,174.90 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $977.24 | Professional | None | $501.19 | $501.19 | $977.24 |
Security Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Security Health Setting Professional Modifier None Typical Low $851.14 Median $1,659.59 Typical High $1,905.46 | Professional | None | $851.14 | $1,659.59 | $1,905.46 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,754.23 Typical High $4,677.35 | Facility | None | $707.95 | $2,754.23 | $4,677.35 |
United Setting Professional Modifier None Typical Low $309.03 Median $870.96 Typical High $1,479.11 | Professional | None | $309.03 | $870.96 | $1,479.11 |
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 $190.55 Median $190.55 Typical High $1,698.24 | Professional | 52 · Reduced service | $190.55 | $190.55 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $691.83 | Professional | 53 · Discontinued | $75.86 | $75.86 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $288.40 | $288.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $512.86 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $346.74 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $2,398.83 |
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
$1,230
AK $1,380UT $240
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.