How much rates vary
Facilitymedian $141 · 10th to 90th $89 to $380Professionalmedian $123 · 10th to 90th $83 to $288
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 $89.13 Median $89.13 Typical High $120.23 | Facility | None | $89.13 | $89.13 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $120.23 | Professional | None | $89.13 | $109.65 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $316.23 | Professional | None | $93.33 | $123.03 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $380.19 Typical High $575.44 | Facility | None | $338.84 | $380.19 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $245.47 | Professional | None | $69.18 | $93.33 | $245.47 |
DeanCare Setting Facility Modifier None Typical Low $104.71 Median $141.25 Typical High $257.04 | Facility | None | $104.71 | $141.25 | $257.04 |
DeanCare Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $316.23 | Professional | None | $173.78 | $229.09 | $316.23 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $141.25 Typical High $257.04 | Facility | None | $104.71 | $141.25 | $257.04 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $794.33 | Professional | None | $117.49 | $138.04 | $794.33 |
Network Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $199.53 | Facility | None | $144.54 | $144.54 | $199.53 |
Network Health Setting Professional Modifier None Typical Low $87.10 Median $213.80 Typical High $269.15 | Professional | None | $87.10 | $213.80 | $269.15 |
Prevea360 Setting Facility Modifier None Typical Low $104.71 Median $141.25 Typical High $257.04 | Facility | None | $104.71 | $141.25 | $257.04 |
Quartz Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $269.15 | Professional | None | $83.18 | $131.83 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $251.19 | Professional | None | $69.18 | $93.33 | $251.19 |
Security Health Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | None | $117.49 | $117.49 | $154.88 |
Security Health Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $288.40 | Professional | None | $158.49 | $186.21 | $288.40 |
The Alliance Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $354.81 | Professional | None | $83.18 | $128.82 | $354.81 |
United Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $218.78 | Professional | None | $85.11 | $117.49 | $218.78 |
12 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 $44.67 Median $44.67 Typical High $60.26 | Facility | 52 · Reduced service | $44.67 | $44.67 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $23.99 | Facility | 53 · Discontinued | $17.78 | $17.78 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $18.20 | Facility | 55 · Aftercare only | $13.49 | $13.49 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $12.02 | Facility | 56 · Pre-op care only | $8.91 | $8.91 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $53.70 Typical High $60.26 | Professional | 52 · Reduced service | $44.67 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.88 Typical High $23.99 | Professional | 53 · Discontinued | $17.78 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.22 Typical High $18.20 | Professional | 55 · Aftercare only | $13.49 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.91 | $10.72 | $12.02 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.18 Median $36.31 Typical High $50.12 | Professional | 80 · Assistant surgeon | $28.18 | $36.31 | $50.12 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.18 Median $36.31 Typical High $50.12 | Professional | 81 · Minimal assistant surgeon | $28.18 | $36.31 | $50.12 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.18 Median $36.31 Typical High $50.12 | Professional | 82 · Assistant surgeon, no resident | $28.18 | $36.31 | $50.12 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $24.55 Median $31.62 Typical High $44.67 | Professional | AS · PA/NP assist | $24.55 | $31.62 | $44.67 |
Where Wisconsin sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 17th of 51
$123
AK $331NJ $81.28
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.