How much rates vary
Facilitymedian $27 · 10th to 90th $18 to $54Professionalmedian $31 · 10th to 90th $18 to $81
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 $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $151.36 | Professional | None | $18.20 | $18.20 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $40.74 Typical High $69.18 | Professional | None | $18.20 | $40.74 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $52.48 Typical High $77.62 | Facility | None | $45.71 | $52.48 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $51.29 | Professional | None | $19.50 | $19.50 | $51.29 |
DeanCare Setting Facility Modifier None Typical Low $16.22 Median $20.89 Typical High $35.48 | Facility | None | $16.22 | $20.89 | $35.48 |
DeanCare Setting Professional Modifier None Typical Low $30.20 Median $35.48 Typical High $41.69 | Professional | None | $30.20 | $35.48 | $41.69 |
Medica Setting Facility Modifier None Typical Low $16.22 Median $20.89 Typical High $35.48 | Facility | None | $16.22 | $20.89 | $35.48 |
Medica Setting Professional Modifier None Typical Low $22.91 Median $44.67 Typical High $162.18 | Professional | None | $22.91 | $44.67 | $162.18 |
Network Health Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $35.48 | Facility | None | $26.92 | $26.92 | $35.48 |
Network Health Setting Professional Modifier None Typical Low $25.12 Median $41.69 Typical High $44.67 | Professional | None | $25.12 | $41.69 | $44.67 |
Prevea360 Setting Facility Modifier None Typical Low $16.22 Median $20.89 Typical High $35.48 | Facility | None | $16.22 | $20.89 | $35.48 |
Quartz Setting Professional Modifier None Typical Low $20.42 Median $38.90 Typical High $60.26 | Professional | None | $20.42 | $38.90 | $60.26 |
Quartz Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $28.18 | Professional | None | $19.50 | $19.50 | $28.18 |
Security Health Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Security Health Setting Professional Modifier None Typical Low $23.44 Median $32.36 Typical High $61.66 | Professional | None | $23.44 | $32.36 | $61.66 |
United Setting Professional Modifier None Typical Low $19.05 Median $30.90 Typical High $69.18 | Professional | None | $19.05 | $30.90 | $69.18 |
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 $9.12 Median $9.12 Typical High $75.86 | Professional | 52 · Reduced service | $9.12 | $9.12 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $30.20 | Professional | 53 · Discontinued | $3.63 | $3.63 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $22.39 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $15.14 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $15.14 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.90 Median $5.75 Typical High $6.61 | Professional | 80 · Assistant surgeon | $4.90 | $5.75 | $6.61 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.90 Median $5.75 Typical High $6.61 | Professional | 81 · Minimal assistant surgeon | $4.90 | $5.75 | $6.61 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.90 Median $5.75 Typical High $6.61 | Professional | 82 · Assistant surgeon, no resident | $4.90 | $5.75 | $6.61 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $4.27 Median $5.01 Typical High $5.75 | Professional | AS · PA/NP assist | $4.27 | $5.01 | $5.75 |
Where Wisconsin sits
The same service costs 3.4 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· 9th of 51
$30.90
AK $50.12FL $14.79
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.