How much rates vary
Facilitymedian $6,761 · 10th to 90th $832 to $16,982Professionalmedian $2,399 · 10th to 90th $1,023 to $3,631
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 $1,023.29 Median $1,023.29 Typical High $14,454.40 | Facility | None | $1,023.29 | $1,023.29 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $8,128.31 | Professional | None | $1,023.29 | $1,023.29 | $8,128.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $11,220.18 Typical High $16,982.44 | Facility | None | $6,606.93 | $11,220.18 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $2,630.27 Typical High $3,630.78 | Professional | None | $1,071.52 | $2,630.27 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $416.87 Typical High $575.44 | Professional | 80 · Assistant surgeon | $181.97 | $416.87 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $363.08 Typical High $501.19 | Professional | AS · PA/NP assist | $147.91 | $363.08 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,187.76 Typical High $3,630.78 | Facility | None | $812.83 | $2,187.76 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,148.15 | $1,778.28 | $2,951.21 |
DeanCare Setting Facility Modifier None Typical Low $1,000.00 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,000.00 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $2,884.03 | Professional | None | $1,513.56 | $2,238.72 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $2,454.71 Typical High $4,168.69 | Professional | None | $1,000.00 | $2,454.71 | $4,168.69 |
Network Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $2,089.30 | Facility | None | $1,258.93 | $1,778.28 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,137.96 Typical High $2,691.53 | Professional | None | $1,230.27 | $2,137.96 | $2,691.53 |
Prevea360 Setting Facility Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,819.70 | Facility | None | $776.25 | $1,023.29 | $1,819.70 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $1,905.46 Typical High $3,630.78 | Professional | None | $891.25 | $1,905.46 | $3,630.78 |
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 $1,202.26 Median $1,202.26 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,202.26 | $2,398.83 |
Security Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Security Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,570.40 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,570.40 | $2,884.03 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $812.83 Median $2,187.76 Typical High $3,890.45 | Professional | None | $812.83 | $2,187.76 | $3,890.45 |
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 $4,073.80 | Professional | 52 · Reduced service | $501.19 | $501.19 | $4,073.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $1,621.81 | Professional | 53 · Discontinued | $204.17 | $204.17 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $6,025.60 | Professional | 54 · Surgery only | $758.58 | $758.58 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $1,230.27 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $812.83 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $5,623.41 |
Where Wisconsin sits
The same service costs 6.6 times more in Alaska than in Texas. 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
$2,630
AK $2,884TX $437
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.