How much rates vary
Facilitymedian $145 · 10th to 90th $74 to $631Professionalmedian $126 · 10th to 90th $74 to $331
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $457.09 | Professional | None | $74.13 | $74.13 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $162.18 Typical High $281.84 | Professional | None | $72.44 | $162.18 | $281.84 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $100.00 | Professional | None | $66.07 | $66.07 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $208.93 Typical High $346.74 | Facility | None | $186.21 | $208.93 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $208.93 | Professional | None | $79.43 | $79.43 | $208.93 |
DeanCare Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $144.54 | Facility | None | $66.07 | $83.18 | $144.54 |
DeanCare Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $169.82 | Professional | None | $125.89 | $147.91 | $169.82 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $144.54 Typical High $1,778.28 | Facility | None | $79.43 | $144.54 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $194.98 Typical High $851.14 | Professional | None | $89.13 | $194.98 | $851.14 |
Network Health Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $144.54 | Facility | None | $107.15 | $107.15 | $144.54 |
Network Health Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $181.97 | Professional | None | $100.00 | $165.96 | $181.97 |
Prevea360 Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $144.54 | Facility | None | $66.07 | $83.18 | $144.54 |
Quartz Setting Professional Modifier None Typical Low $67.61 Median $134.90 Typical High $208.93 | Professional | None | $67.61 | $134.90 | $208.93 |
Quartz Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Quartz Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $114.82 | Professional | None | $79.43 | $79.43 | $114.82 |
Security Health Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Security Health Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $245.47 | Professional | None | $109.65 | $162.18 | $245.47 |
The Alliance Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $302.00 | Professional | None | $109.65 | $169.82 | $302.00 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
United Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $281.84 | Professional | None | $75.86 | $125.89 | $281.84 |
8 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 $36.31 Median $36.31 Typical High $229.09 | Professional | 52 · Reduced service | $36.31 | $36.31 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $91.20 | Professional | 53 · Discontinued | $14.79 | $14.79 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $69.18 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $45.71 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $45.71 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.95 Median $23.44 Typical High $26.92 | Professional | 80 · Assistant surgeon | $19.95 | $23.44 | $26.92 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.95 Median $23.44 Typical High $26.92 | Professional | 81 · Minimal assistant surgeon | $19.95 | $23.44 | $26.92 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.95 Median $23.44 Typical High $26.92 | Professional | 82 · Assistant surgeon, no resident | $19.95 | $23.44 | $26.92 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $20.42 Typical High $23.44 | Professional | AS · PA/NP assist | $17.38 | $20.42 | $23.44 |
Where Wisconsin sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 7th of 51
$126
AK $182FL $57.54
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.