How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,202 to $10,965Professionalmedian $1,820 · 10th to 90th $631 to $4,786
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 $891.25 Median $8,317.64 Typical High $14,454.40 | Facility | None | $891.25 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $7,762.47 | Professional | None | $891.25 | $891.25 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $2,290.87 Typical High $4,786.30 | Professional | None | $660.69 | $2,290.87 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $3,467.37 Typical High $7,079.46 | Professional | 50 · Both sides | $977.24 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $1,445.44 Typical High $3,019.95 | Professional | 62 · Two surgeons | $416.87 | $1,445.44 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,511.89 Typical High $4,365.16 | Facility | None | $1,202.26 | $2,511.89 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $1,258.93 Typical High $2,398.83 | Professional | None | $478.63 | $1,258.93 | $2,398.83 |
DeanCare Setting Facility Modifier None Typical Low $758.58 Median $5,128.61 Typical High $9,332.54 | Facility | None | $758.58 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,621.81 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $5,623.41 Typical High $10,964.78 | Facility | None | $933.25 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $2,041.74 Typical High $4,786.30 | Professional | None | $660.69 | $2,041.74 | $4,786.30 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,445.44 | $2,398.83 |
Prevea360 Setting Facility Modifier None Typical Low $707.95 Median $933.25 Typical High $1,258.93 | Facility | None | $707.95 | $933.25 | $1,258.93 |
Quartz Setting Professional Modifier None Typical Low $616.60 Median $1,258.93 Typical High $2,089.30 | Professional | None | $616.60 | $1,258.93 | $2,089.30 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,786.30 | Facility | None | $933.25 | $3,162.28 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $478.63 Median $1,258.93 Typical High $1,380.38 | Professional | None | $478.63 | $1,258.93 | $1,380.38 |
Security Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Security Health Setting Professional Modifier None Typical Low $2,511.89 Median $4,168.69 Typical High $6,309.57 | Professional | None | $2,511.89 | $4,168.69 | $6,309.57 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,951.21 | Professional | None | $602.56 | $1,318.26 | $2,951.21 |
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 $446.68 Median $446.68 Typical High $3,890.45 | Professional | 52 · Reduced service | $446.68 | $446.68 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $1,584.89 | Professional | 53 · Discontinued | $177.83 | $177.83 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $5,888.44 | Professional | 54 · Surgery only | $660.69 | $660.69 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $1,174.90 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $776.25 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $776.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $5,495.41 |
Where Wisconsin sits
The same service costs 8.5 times more in Wyoming 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
WY $3,020UT $355
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.