How much rates vary
Facilitymedian $141 · 10th to 90th $72 to $389Professionalmedian $95 · 10th to 90th $55 to $209
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $72.44 Median $72.44 Typical High $120.23 | Facility | None | $72.44 | $72.44 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $120.23 | Professional | None | $72.44 | $95.50 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $199.53 | Professional | None | $50.12 | $89.13 | $199.53 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $389.05 Typical High $575.44 | Facility | None | $338.84 | $389.05 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $93.33 Typical High $186.21 | Professional | None | $50.12 | $93.33 | $186.21 |
DeanCare Setting Facility Modifier None Typical Low $85.11 Median $141.25 Typical High $239.88 | Facility | None | $85.11 | $141.25 | $239.88 |
DeanCare Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $309.03 | Professional | None | $60.26 | $60.26 | $309.03 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $151.36 Typical High $331.13 | Facility | None | $70.79 | $151.36 | $331.13 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $794.33 | Professional | None | $102.33 | $151.36 | $794.33 |
Network Health Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $162.18 | Facility | None | $114.82 | $114.82 | $162.18 |
Network Health Setting Professional Modifier None Typical Low $74.13 Median $158.49 Typical High $269.15 | Professional | None | $74.13 | $158.49 | $269.15 |
Prevea360 Setting Facility Modifier None Typical Low $85.11 Median $141.25 Typical High $239.88 | Facility | None | $85.11 | $141.25 | $239.88 |
Quartz Setting Professional Modifier None Typical Low $67.61 Median $141.25 Typical High $281.84 | Professional | None | $67.61 | $141.25 | $281.84 |
Quartz Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $251.19 | Professional | None | $56.23 | $93.33 | $251.19 |
Security Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $117.49 | Professional | None | $70.79 | $70.79 | $117.49 |
Security Health Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $245.47 | Professional | None | $75.86 | $123.03 | $245.47 |
The Alliance Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $338.84 | Professional | None | $75.86 | $75.86 | $338.84 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
United Setting Professional Modifier None Typical Low $52.48 Median $100.00 Typical High $173.78 | Professional | None | $52.48 | $100.00 | $173.78 |
10 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 Facility Modifier 52 · Reduced service Typical Low $36.31 Median $36.31 Typical High $60.26 | Facility | 52 · Reduced service | $36.31 | $36.31 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $18.20 | Facility | 55 · Aftercare only | $10.96 | $10.96 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $12.02 | Facility | 56 · Pre-op care only | $7.24 | $7.24 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $36.31 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.14 Typical High $18.20 | Professional | 55 · Aftercare only | $10.96 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.24 | $10.00 | $12.02 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.77 Median $9.77 Typical High $50.12 | Professional | 80 · Assistant surgeon | $9.77 | $9.77 | $50.12 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.77 Median $9.77 Typical High $50.12 | Professional | 81 · Minimal assistant surgeon | $9.77 | $9.77 | $50.12 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.77 Median $9.77 Typical High $50.12 | Professional | 82 · Assistant surgeon, no resident | $9.77 | $9.77 | $50.12 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $8.51 Median $8.51 Typical High $43.65 | Professional | AS · PA/NP assist | $8.51 | $8.51 | $43.65 |
Where Wisconsin sits
The same service costs 4.3 times more in Alaska than in North Carolina. 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· 22nd of 51
$95.50
AK $263NC $61.66
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.