How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,698 to $14,125Professionalmedian $5,623 · 10th to 90th $1,820 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 $1,698.24 Median $8,511.38 Typical High $14,454.40 | Facility | None | $1,698.24 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $17,782.79 | Professional | None | $1,698.24 | $1,698.24 | $17,782.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $6,456.54 Typical High $11,748.98 | Professional | None | $2,344.23 | $6,456.54 | $11,748.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,467.37 Median $9,549.93 Typical High $17,782.79 | Professional | 50 · Both sides | $3,467.37 | $9,549.93 | $17,782.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $1,047.13 Typical High $1,862.09 | Professional | 80 · Assistant surgeon | $371.54 | $1,047.13 | $1,862.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $912.01 Typical High $1,659.59 | Professional | AS · PA/NP assist | $323.59 | $912.01 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $5,495.41 Typical High $8,317.64 | Facility | None | $1,023.29 | $5,495.41 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $3,890.45 Typical High $6,760.83 | Professional | None | $2,454.71 | $3,890.45 | $6,760.83 |
DeanCare Setting Facility Modifier None Typical Low $2,041.74 Median $5,623.41 Typical High $10,232.93 | Facility | None | $2,041.74 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $3,311.31 Median $4,897.79 Typical High $6,025.60 | Professional | None | $3,311.31 | $4,897.79 | $6,025.60 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $6,606.93 Typical High $13,803.84 | Facility | None | $1,412.54 | $6,606.93 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $2,137.96 Median $5,623.41 Typical High $12,022.64 | Professional | None | $2,137.96 | $5,623.41 | $12,022.64 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $6,025.60 | Professional | None | $2,691.53 | $4,677.35 | $6,025.60 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $2,041.74 Typical High $3,715.35 | Facility | None | $933.25 | $2,041.74 | $3,715.35 |
Quartz Setting Professional Modifier None Typical Low $1,819.70 Median $4,168.69 Typical High $7,943.28 | Professional | None | $1,819.70 | $4,168.69 | $7,943.28 |
Quartz Setting Facility Modifier None Typical Low $831.76 Median $5,011.87 Typical High $8,317.64 | Facility | None | $831.76 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $5,623.41 | Professional | None | $2,511.89 | $2,511.89 | $5,623.41 |
Security Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Security Health Setting Professional Modifier None Typical Low $5,754.40 Median $8,128.31 Typical High $10,471.29 | Professional | None | $5,754.40 | $8,128.31 | $10,471.29 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $5,011.87 Typical High $9,772.37 | Professional | None | $1,737.80 | $5,011.87 | $9,772.37 |
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 $851.14 Median $851.14 Typical High $8,912.51 | Professional | 52 · Reduced service | $851.14 | $851.14 | $8,912.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $3,630.78 | Professional | 53 · Discontinued | $338.84 | $338.84 | $3,630.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $13,489.63 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $13,489.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $2,691.53 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $2,691.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $1,778.28 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $1,778.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $12,589.25 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $12,589.25 |
Where Wisconsin sits
The same service costs 6.9 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
$6,166
AK $7,586TX $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.