How much rates vary
Facilitymedian $7,943 · 10th to 90th $813 to $19,498Professionalmedian $5,248 · 10th to 90th $1,660 to $10,715
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 $1,445.44 Median $1,445.44 Typical High $14,454.40 | Facility | None | $1,445.44 | $1,445.44 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $17,378.01 | Professional | None | $1,445.44 | $1,445.44 | $17,378.01 |
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 $1,949.84 Median $6,165.95 Typical High $10,715.19 | Professional | None | $1,949.84 | $6,165.95 | $10,715.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $3,890.45 Typical High $6,760.83 | Professional | 62 · Two surgeons | $1,230.27 | $3,890.45 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $1,000.00 Typical High $1,698.24 | Professional | 80 · Assistant surgeon | $309.03 | $1,000.00 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $870.96 Typical High $1,479.11 | Professional | AS · PA/NP assist | $275.42 | $870.96 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,073.80 Typical High $6,309.57 | Facility | None | $812.83 | $4,073.80 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $3,630.78 Typical High $7,413.10 | Professional | None | $2,570.40 | $3,630.78 | $7,413.10 |
DeanCare Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,737.80 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $5,623.41 | Professional | None | $2,818.38 | $4,168.69 | $5,623.41 |
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 $1,819.70 Median $5,011.87 Typical High $11,748.98 | Professional | None | $1,819.70 | $5,011.87 | $11,748.98 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $3,235.94 | Facility | None | $2,089.30 | $2,290.87 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,981.07 Typical High $7,413.10 | Professional | None | $2,290.87 | $3,981.07 | $7,413.10 |
Prevea360 Setting Facility Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $3,548.13 | Facility | None | $1,445.44 | $1,862.09 | $3,548.13 |
Quartz Setting Professional Modifier None Typical Low $1,862.09 Median $4,265.80 Typical High $6,760.83 | Professional | None | $1,862.09 | $4,265.80 | $6,760.83 |
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 $2,818.38 Median $3,019.95 Typical High $6,025.60 | Professional | None | $2,818.38 | $3,019.95 | $6,025.60 |
Security Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
Security Health Setting Professional Modifier None Typical Low $5,754.40 Median $9,120.11 Typical High $11,481.54 | Professional | None | $5,754.40 | $9,120.11 | $11,481.54 |
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 $1,659.59 Median $4,786.30 Typical High $8,912.51 | Professional | None | $1,659.59 | $4,786.30 | $8,912.51 |
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 $724.44 Median $724.44 Typical High $8,709.64 | Professional | 52 · Reduced service | $724.44 | $724.44 | $8,709.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $3,467.37 | Professional | 53 · Discontinued | $288.40 | $288.40 | $3,467.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $12,882.50 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $12,882.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $2,570.40 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $2,570.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $1,737.80 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $1,737.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $12,022.64 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $12,022.64 |
Where Wisconsin sits
The same service costs 5.9 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
$5,495
AK $6,918TX $1,175
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.