How much rates vary
Facilitymedian $7,943 · 10th to 90th $813 to $19,498Professionalmedian $7,413 · 10th to 90th $2,291 to $14,791
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 $1,995.26 Median $1,995.26 Typical High $14,454.40 | Facility | None | $1,995.26 | $1,995.26 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $27,542.29 | Professional | None | $1,995.26 | $1,995.26 | $27,542.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $15,488.17 Typical High $26,302.68 | Facility | None | $10,964.78 | $15,488.17 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,630.27 Median $8,511.38 Typical High $15,135.61 | Professional | None | $2,630.27 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,621.81 Median $5,370.32 Typical High $9,332.54 | Professional | 62 · Two surgeons | $1,621.81 | $5,370.32 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $1,380.38 Typical High $2,398.83 | Professional | 80 · Assistant surgeon | $436.52 | $1,380.38 | $2,398.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $1,202.26 Typical High $2,089.30 | Professional | AS · PA/NP assist | $363.08 | $1,202.26 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,623.41 Typical High $8,709.64 | Facility | None | $812.83 | $5,623.41 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $5,011.87 Typical High $10,471.29 | Professional | None | $3,548.13 | $5,011.87 | $10,471.29 |
DeanCare Setting Facility Modifier None Typical Low $2,398.83 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,398.83 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,890.45 Median $5,754.40 Typical High $7,943.28 | Professional | None | $3,890.45 | $5,754.40 | $7,943.28 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,570.40 Typical High $18,197.01 | Facility | None | $436.52 | $2,570.40 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,570.40 Median $7,079.46 Typical High $16,218.10 | Professional | None | $2,570.40 | $7,079.46 | $16,218.10 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $3,162.28 Typical High $4,466.84 | Facility | None | $2,089.30 | $3,162.28 | $4,466.84 |
Network Health Setting Professional Modifier None Typical Low $3,162.28 Median $5,495.41 Typical High $10,232.93 | Professional | None | $3,162.28 | $5,495.41 | $10,232.93 |
Prevea360 Setting Facility Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $5,011.87 | Facility | None | $1,995.26 | $2,570.40 | $5,011.87 |
Quartz Setting Professional Modifier None Typical Low $2,511.89 Median $5,754.40 Typical High $9,332.54 | Professional | None | $2,511.89 | $5,754.40 | $9,332.54 |
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 $3,890.45 Median $4,168.69 Typical High $8,511.38 | Professional | None | $3,890.45 | $4,168.69 | $8,511.38 |
Security Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
Security Health Setting Professional Modifier None Typical Low $8,128.31 Median $12,589.25 Typical High $15,848.93 | Professional | None | $8,128.31 | $12,589.25 | $15,848.93 |
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 $2,290.87 Median $6,606.93 Typical High $12,302.69 | Professional | None | $2,290.87 | $6,606.93 | $12,302.69 |
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 $1,000.00 Median $1,000.00 Typical High $13,803.84 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $13,803.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $5,495.41 | Professional | 53 · Discontinued | $407.38 | $407.38 | $5,495.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $20,417.38 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $20,417.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $4,073.80 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $4,073.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $2,754.23 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $2,754.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $19,054.61 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $19,054.61 |
Where Wisconsin sits
The same service costs 14.1 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
$7,413
AK $9,772TX $692
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.