How much rates vary
Facilitymedian $437 · 10th to 90th $309 to $912Professionalmedian $417 · 10th to 90th $288 to $1,072
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 $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $1,445.44 | Professional | None | $288.40 | $309.03 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $645.65 Typical High $1,023.29 | Professional | None | $269.15 | $645.65 | $1,023.29 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $416.87 | Professional | None | $269.15 | $275.42 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $891.25 Typical High $1,318.26 | Facility | None | $776.25 | $891.25 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $851.14 | Professional | None | $316.23 | $331.13 | $851.14 |
DeanCare Setting Facility Modifier None Typical Low $275.42 Median $346.74 Typical High $602.56 | Facility | None | $275.42 | $346.74 | $602.56 |
DeanCare Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $707.95 | Professional | None | $524.81 | $575.44 | $707.95 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $346.74 Typical High $602.56 | Facility | None | $275.42 | $346.74 | $602.56 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $588.84 Typical High $1,905.46 | Professional | None | $288.40 | $588.84 | $1,905.46 |
Network Health Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $478.63 | Facility | None | $436.52 | $436.52 | $478.63 |
Network Health Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $741.31 | Professional | None | $371.54 | $537.03 | $741.31 |
Prevea360 Setting Facility Modifier None Typical Low $275.42 Median $346.74 Typical High $602.56 | Facility | None | $275.42 | $346.74 | $602.56 |
Quartz Setting Professional Modifier None Typical Low $346.74 Median $660.69 Typical High $977.24 | Professional | None | $346.74 | $660.69 | $977.24 |
Quartz Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $457.09 | Professional | None | $331.13 | $331.13 | $457.09 |
Security Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Security Health Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $1,023.29 | Professional | None | $323.59 | $537.03 | $1,023.29 |
The Alliance Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,000.00 | Professional | None | $549.54 | $724.44 | $1,000.00 |
United Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $912.01 | Professional | None | $251.19 | $416.87 | $912.01 |
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 $151.36 Median $151.36 Typical High $724.44 | Professional | 52 · Reduced service | $151.36 | $151.36 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $61.66 Typical High $288.40 | Professional | 53 · Discontinued | $60.26 | $61.66 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $218.78 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.90 Typical High $144.54 | Professional | 56 · Pre-op care only | $30.20 | $30.90 | $144.54 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $93.33 Typical High $112.20 | Professional | 80 · Assistant surgeon | $83.18 | $93.33 | $112.20 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $83.18 Median $93.33 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $83.18 | $93.33 | $112.20 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $83.18 Median $93.33 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $83.18 | $93.33 | $112.20 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $81.28 Typical High $97.72 | Professional | AS · PA/NP assist | $72.44 | $81.28 | $97.72 |
Where Wisconsin sits
The same service costs 2.8 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· 13th of 51
$417
AK $661NY $234
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.