How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,413 to $14,454Professionalmedian $3,311 · 10th to 90th $1,047 to $7,762
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 $1,000.00 Median $8,511.38 Typical High $14,454.40 | Facility | None | $1,000.00 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $10,471.29 | Professional | None | $1,000.00 | $1,000.00 | $10,471.29 |
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 $1,318.26 Median $3,715.35 Typical High $8,511.38 | Professional | None | $1,318.26 | $3,715.35 | $8,511.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $5,495.41 Typical High $12,589.25 | Professional | 50 · Both sides | $1,995.26 | $5,495.41 | $12,589.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $2,344.23 Typical High $5,370.32 | Professional | 62 · Two surgeons | $831.76 | $2,344.23 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $588.84 Typical High $1,348.96 | Professional | 80 · Assistant surgeon | $213.80 | $588.84 | $1,348.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $512.86 Typical High $1,174.90 | Professional | AS · PA/NP assist | $186.21 | $512.86 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,630.78 Typical High $7,585.78 | Facility | None | $1,023.29 | $3,630.78 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $3,981.07 | Professional | None | $1,698.24 | $2,398.83 | $3,981.07 |
DeanCare Setting Facility Modifier None Typical Low $1,174.90 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,174.90 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $3,548.13 | Professional | None | $1,905.46 | $2,818.38 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $6,606.93 Typical High $15,135.61 | Facility | None | $1,174.90 | $6,606.93 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $2,884.03 Typical High $6,309.57 | Professional | None | $1,230.27 | $2,884.03 | $6,309.57 |
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 $1,548.82 Median $2,691.53 Typical High $3,388.44 | Professional | None | $1,548.82 | $2,691.53 | $3,388.44 |
Prevea360 Setting Facility Modifier None Typical Low $977.24 Median $1,174.90 Typical High $2,238.72 | Facility | None | $977.24 | $1,174.90 | $2,238.72 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $2,454.71 Typical High $4,570.88 | Professional | None | $1,071.52 | $2,454.71 | $4,570.88 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $5,011.87 Typical High $8,317.64 | Facility | None | $812.83 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,819.70 | $1,995.26 | $3,162.28 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Security Health Setting Professional Modifier None Typical Low $4,265.80 Median $6,606.93 Typical High $7,413.10 | Professional | None | $4,265.80 | $6,606.93 | $7,413.10 |
The Alliance Setting Professional Modifier None Typical Low $3,467.37 Median $6,309.57 Typical High $7,244.36 | Professional | None | $3,467.37 | $6,309.57 | $7,244.36 |
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 $977.24 Median $2,754.23 Typical High $5,011.87 | Professional | None | $977.24 | $2,754.23 | $5,011.87 |
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 $5,248.07 | Professional | 52 · Reduced service | $501.19 | $501.19 | $5,248.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $2,089.30 | Professional | 53 · Discontinued | $199.53 | $199.53 | $2,089.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $7,943.28 | Professional | 54 · Surgery only | $758.58 | $758.58 | $7,943.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $1,584.89 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $1,584.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $1,047.13 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $1,047.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $7,413.10 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $7,413.10 |
Where Wisconsin sits
The same service costs 3.7 times more in Alaska than in West Virginia. 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
AK $11,610WV $3,177
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.