How much rates vary
Facilitymedian $6,761 · 10th to 90th $525 to $16,982Professionalmedian $741 · 10th to 90th $309 to $1,148
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 $309.03 Median $309.03 Typical High $14,454.40 | Facility | None | $309.03 | $309.03 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $4,073.80 | Professional | None | $295.12 | $309.03 | $4,073.80 |
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 $323.59 Median $812.83 Typical High $1,148.15 | Professional | None | $323.59 | $812.83 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $128.82 Typical High $181.97 | Professional | 80 · Assistant surgeon | $51.29 | $128.82 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $114.82 Typical High $158.49 | Professional | AS · PA/NP assist | $44.67 | $114.82 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $758.58 Typical High $1,584.89 | Facility | None | $660.69 | $758.58 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $891.25 | Professional | None | $363.08 | $549.54 | $891.25 |
DeanCare Setting Facility Modifier None Typical Low $302.00 Median $7,943.28 Typical High $14,454.40 | Facility | None | $302.00 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $933.25 | Professional | None | $457.09 | $676.08 | $933.25 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $2,454.71 Typical High $18,197.01 | Facility | None | $407.38 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $776.25 Typical High $1,318.26 | Professional | None | $316.23 | $776.25 | $1,318.26 |
Network Health Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $549.54 | Facility | None | $380.19 | $380.19 | $549.54 |
Network Health Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $851.14 | Professional | None | $371.54 | $660.69 | $851.14 |
Prevea360 Setting Facility Modifier None Typical Low $234.42 Median $309.03 Typical High $575.44 | Facility | None | $234.42 | $309.03 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $275.42 Median $575.44 Typical High $1,096.48 | Professional | None | $275.42 | $575.44 | $1,096.48 |
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 $363.08 Median $363.08 Typical High $724.44 | Professional | None | $363.08 | $363.08 | $724.44 |
Security Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Security Health Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $891.25 | Professional | None | $501.19 | $776.25 | $891.25 |
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 $257.04 Median $691.83 Typical High $1,202.26 | Professional | None | $257.04 | $691.83 | $1,202.26 |
5 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 $154.88 Median $154.88 Typical High $2,041.74 | Professional | 52 · Reduced service | $154.88 | $154.88 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $812.83 | Professional | 53 · Discontinued | $61.66 | $61.66 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $3,019.95 | Professional | 54 · Surgery only | $229.09 | $229.09 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $602.56 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $407.38 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $407.38 |
Where Wisconsin sits
The same service costs 3.2 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
$851
AK $871TX $275
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.