How much rates vary
Facilitymedian $1,820 · 10th to 90th $513 to $6,026Professionalmedian $2,754 · 10th to 90th $955 to $7,244
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 $1,348.96 Median $6,456.54 Typical High $14,454.40 | Facility | None | $1,348.96 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $10,232.93 | Professional | None | $1,348.96 | $1,348.96 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,202.26 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $3,388.44 Typical High $7,244.36 | Professional | None | $977.24 | $3,388.44 | $7,244.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $5,128.61 Typical High $10,715.19 | Professional | 50 · Both sides | $1,479.11 | $5,128.61 | $10,715.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $537.03 Typical High $1,148.15 | Professional | 80 · Assistant surgeon | $154.88 | $537.03 | $1,148.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $478.63 Typical High $1,000.00 | Professional | AS · PA/NP assist | $138.04 | $478.63 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,570.40 Typical High $3,630.78 | Facility | None | $954.99 | $2,570.40 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,905.46 Typical High $3,630.78 | Professional | None | $724.44 | $1,905.46 | $3,630.78 |
DeanCare Setting Facility Modifier None Typical Low $1,071.52 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,071.52 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,884.03 | Professional | None | $1,698.24 | $2,398.83 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $1,148.15 Typical High $3,801.89 | Facility | None | $257.04 | $1,148.15 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $7,244.36 | Professional | None | $1,000.00 | $3,090.30 | $7,244.36 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $1,445.44 Typical High $2,344.23 | Facility | None | $831.76 | $1,445.44 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $3,630.78 | Professional | None | $2,089.30 | $2,089.30 | $3,630.78 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,862.09 | Facility | None | $933.25 | $1,148.15 | $1,862.09 |
Quartz Setting Professional Modifier None Typical Low $933.25 Median $1,905.46 Typical High $3,162.28 | Professional | None | $933.25 | $1,905.46 | $3,162.28 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,290.87 Typical High $3,467.37 | Facility | None | $758.58 | $2,290.87 | $3,467.37 |
Quartz Setting Professional Modifier None Typical Low $724.44 Median $1,905.46 Typical High $2,089.30 | Professional | None | $724.44 | $1,905.46 | $2,089.30 |
Security Health Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Security Health Setting Professional Modifier None Typical Low $3,090.30 Median $6,309.57 Typical High $9,549.93 | Professional | None | $3,090.30 | $6,309.57 | $9,549.93 |
The Alliance Setting Professional Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $5,888.44 | Professional | None | $1,318.26 | $2,754.23 | $5,888.44 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,995.26 Typical High $4,466.84 | Professional | None | $870.96 | $1,995.26 | $4,466.84 |
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 $676.08 Median $676.08 Typical High $5,128.61 | Professional | 52 · Reduced service | $676.08 | $676.08 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $2,041.74 | Professional | 53 · Discontinued | $269.15 | $269.15 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $7,585.78 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $1,513.56 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $1,023.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $7,079.46 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $7,079.46 |
Where Wisconsin sits
The same service costs 7.2 times more in Alaska than in Utah. 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· 3rd of 51
$2,399
AK $3,890UT $537
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.