How much rates vary
Facilitymedian $245 · 10th to 90th $126 to $501Professionalmedian $214 · 10th to 90th $126 to $676
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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $1,047.13 | Professional | None | $125.89 | $125.89 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $281.84 Typical High $478.63 | Professional | None | $123.03 | $281.84 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $363.08 Typical High $537.03 | Facility | None | $316.23 | $363.08 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $354.81 | Professional | None | $134.90 | $134.90 | $354.81 |
DeanCare Setting Facility Modifier None Typical Low $112.20 Median $144.54 Typical High $245.47 | Facility | None | $112.20 | $144.54 | $245.47 |
DeanCare Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $288.40 | Professional | None | $213.80 | $251.19 | $288.40 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $169.82 Typical High $1,548.82 | Facility | None | $112.20 | $169.82 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $331.13 Typical High $1,174.90 | Professional | None | $147.91 | $331.13 | $1,174.90 |
Network Health Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $245.47 | Facility | None | $181.97 | $181.97 | $245.47 |
Network Health Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $309.03 | Professional | None | $173.78 | $281.84 | $309.03 |
Prevea360 Setting Facility Modifier None Typical Low $112.20 Median $144.54 Typical High $245.47 | Facility | None | $112.20 | $144.54 | $245.47 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $234.42 Typical High $354.81 | Professional | None | $117.49 | $234.42 | $354.81 |
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 $134.90 Median $134.90 Typical High $194.98 | Professional | None | $134.90 | $134.90 | $194.98 |
Security Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Security Health Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $426.58 | Professional | None | $190.55 | $275.42 | $426.58 |
The Alliance Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $524.81 | Professional | None | $186.21 | $295.12 | $524.81 |
United Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $478.63 | Professional | None | $128.82 | $213.80 | $478.63 |
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 $63.10 Median $63.10 Typical High $537.03 | Professional | 52 · Reduced service | $63.10 | $63.10 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $213.80 | Professional | 53 · Discontinued | $25.12 | $25.12 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $162.18 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $107.15 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $107.15 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $40.74 Typical High $46.77 | Professional | 80 · Assistant surgeon | $33.88 | $40.74 | $46.77 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.88 Median $40.74 Typical High $46.77 | Professional | 81 · Minimal assistant surgeon | $33.88 | $40.74 | $46.77 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.88 Median $40.74 Typical High $46.77 | Professional | 82 · Assistant surgeon, no resident | $33.88 | $40.74 | $46.77 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $35.48 Typical High $40.74 | Professional | AS · PA/NP assist | $30.20 | $35.48 | $40.74 |
Where Wisconsin sits
The same service costs 3.2 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· 9th of 51
$214
AK $316UT $97.72
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.