How much rates vary
Facilitymedian $1,148 · 10th to 90th $794 to $2,344Professionalmedian $1,148 · 10th to 90th $776 to $3,236
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 $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $4,786.30 | Professional | None | $794.33 | $794.33 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,778.28 Typical High $2,691.53 | Professional | None | $741.31 | $1,778.28 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $3,388.44 | Facility | None | $1,995.26 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $2,238.72 | Professional | None | $812.83 | $851.14 | $2,238.72 |
DeanCare Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $1,548.82 | Facility | None | $707.95 | $912.01 | $1,548.82 |
DeanCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,513.56 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $1,548.82 | Facility | None | $707.95 | $912.01 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,659.59 Typical High $5,370.32 | Professional | None | $812.83 | $1,659.59 | $5,370.32 |
Network Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,288.25 | Facility | None | $1,148.15 | $1,148.15 | $1,288.25 |
Network Health Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $1,949.84 | Professional | None | $977.24 | $1,445.44 | $1,949.84 |
Prevea360 Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $1,548.82 | Facility | None | $707.95 | $912.01 | $1,548.82 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $1,698.24 Typical High $2,511.89 | Professional | None | $891.25 | $1,698.24 | $2,511.89 |
Quartz Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,202.26 | Professional | None | $851.14 | $851.14 | $1,202.26 |
Security Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Security Health Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $2,691.53 | Professional | None | $891.25 | $1,412.54 | $2,691.53 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $2,454.71 | Professional | None | $691.83 | $1,122.02 | $2,454.71 |
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 $398.11 Median $398.11 Typical High $2,511.89 | Professional | 52 · Reduced service | $398.11 | $398.11 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $1,000.00 | Professional | 53 · Discontinued | $158.49 | $158.49 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $758.58 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $501.19 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $501.19 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $239.88 Typical High $295.12 | Professional | 80 · Assistant surgeon | $213.80 | $239.88 | $295.12 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $239.88 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $213.80 | $239.88 | $295.12 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $239.88 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $239.88 | $295.12 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $213.80 Typical High $257.04 | Professional | AS · PA/NP assist | $190.55 | $213.80 | $257.04 |
Where Wisconsin sits
The same service costs 3.2 times more in Alaska than in New York. 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
$1,148
AK $1,778NY $562
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.