How much rates vary
Facilitymedian $7,943 · 10th to 90th $813 to $19,498Professionalmedian $6,607 · 10th to 90th $2,042 to $13,183
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 $1,819.70 Median $1,819.70 Typical High $14,454.40 | Facility | None | $1,819.70 | $1,819.70 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $18,197.01 | Professional | None | $1,819.70 | $1,819.70 | $18,197.01 |
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 $2,454.71 Median $7,762.47 Typical High $13,489.63 | Professional | None | $2,454.71 | $7,762.47 | $13,489.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $1,258.93 Typical High $2,137.96 | Professional | 80 · Assistant surgeon | $389.05 | $1,258.93 | $2,137.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $1,096.48 Typical High $1,905.46 | Professional | AS · PA/NP assist | $346.74 | $1,096.48 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,128.61 Typical High $7,943.28 | Facility | None | $812.83 | $5,128.61 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $4,265.80 Typical High $9,332.54 | Professional | None | $3,235.94 | $4,265.80 | $9,332.54 |
DeanCare Setting Facility Modifier None Typical Low $2,187.76 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,187.76 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,548.13 Median $5,248.07 Typical High $7,079.46 | Professional | None | $3,548.13 | $5,248.07 | $7,079.46 |
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 $2,089.30 Median $5,754.40 Typical High $14,791.08 | Professional | None | $2,089.30 | $5,754.40 | $14,791.08 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $3,235.94 | Facility | None | $2,089.30 | $2,884.03 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $2,884.03 Median $5,011.87 Typical High $9,332.54 | Professional | None | $2,884.03 | $5,011.87 | $9,332.54 |
Prevea360 Setting Facility Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $4,570.88 | Facility | None | $1,819.70 | $2,344.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $2,290.87 Median $5,248.07 Typical High $8,511.38 | Professional | None | $2,290.87 | $5,248.07 | $8,511.38 |
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 $3,467.37 Median $3,801.89 Typical High $7,762.47 | Professional | None | $3,467.37 | $3,801.89 | $7,762.47 |
Security Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
Security Health Setting Professional Modifier None Typical Low $7,244.36 Median $11,481.54 Typical High $14,454.40 | Professional | None | $7,244.36 | $11,481.54 | $14,454.40 |
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 $2,089.30 Median $5,754.40 Typical High $11,220.18 | Professional | None | $2,089.30 | $5,754.40 | $11,220.18 |
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 $912.01 Median $912.01 Typical High $9,120.11 | Professional | 52 · Reduced service | $912.01 | $912.01 | $9,120.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $3,630.78 | Professional | 53 · Discontinued | $363.08 | $363.08 | $3,630.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $13,803.84 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $13,803.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $2,754.23 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $2,754.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $1,819.70 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $1,819.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $12,882.50 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $12,882.50 |
Where Wisconsin sits
The same service costs 8.1 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
$6,761
AK $8,913TX $1,096
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.