How much rates vary
Facilitymedian $166 · 10th to 90th $91 to $355Professionalmedian $117 · 10th to 90th $83 to $331
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 $91.20 Median $91.20 Typical High $95.50 | Facility | None | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $257.04 | Professional | None | $91.20 | $91.20 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $302.00 | Professional | None | $83.18 | $123.03 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $263.03 Typical High $389.05 | Facility | None | $229.09 | $263.03 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $251.19 | Professional | None | $104.71 | $128.82 | $251.19 |
DeanCare Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $177.83 | Facility | None | $81.28 | $102.33 | $177.83 |
DeanCare Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | None | $154.88 | $154.88 | $199.53 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $173.78 Typical High $363.08 | Facility | None | $91.20 | $173.78 | $363.08 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $208.93 Typical High $537.03 | Professional | None | $89.13 | $208.93 | $537.03 |
Network Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $154.88 | Facility | None | $128.82 | $128.82 | $154.88 |
Network Health Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $190.55 | Professional | None | $75.86 | $95.50 | $190.55 |
Prevea360 Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $177.83 | Facility | None | $81.28 | $102.33 | $177.83 |
Quartz Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $295.12 | Professional | None | $93.33 | $162.18 | $295.12 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $125.89 | Professional | None | $72.44 | $104.71 | $125.89 |
Security Health Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Security Health Setting Professional Modifier None Typical Low $93.33 Median $234.42 Typical High $512.86 | Professional | None | $93.33 | $234.42 | $512.86 |
The Alliance Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $199.53 | Professional | None | $85.11 | $144.54 | $199.53 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $363.08 | Professional | None | $81.28 | $117.49 | $363.08 |
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 $44.67 Median $44.67 Typical High $128.82 | Professional | 52 · Reduced service | $44.67 | $44.67 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $51.29 | Professional | 53 · Discontinued | $18.20 | $18.20 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $38.02 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $25.70 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $24.55 Typical High $31.62 | Professional | 80 · Assistant surgeon | $24.55 | $24.55 | $31.62 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $24.55 Median $24.55 Typical High $31.62 | Professional | 81 · Minimal assistant surgeon | $24.55 | $24.55 | $31.62 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $24.55 Median $24.55 Typical High $31.62 | Professional | 82 · Assistant surgeon, no resident | $24.55 | $24.55 | $31.62 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $21.88 Typical High $27.54 | Professional | AS · PA/NP assist | $21.38 | $21.88 | $27.54 |
Where Wisconsin sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 10th of 51
$117
AK $186UT $64.57
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.