How much rates vary
Facilitymedian $51 · 10th to 90th $39 to $186Professionalmedian $46 · 10th to 90th $33 to $151
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 $38.90 Median $44.67 Typical High $46.77 | Facility | None | $38.90 | $44.67 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $46.77 | Professional | None | $38.90 | $42.66 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $158.49 | Professional | None | $36.31 | $43.65 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $134.90 Typical High $204.17 | Facility | None | $120.23 | $134.90 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $38.02 Typical High $93.33 | Professional | None | $27.54 | $38.02 | $93.33 |
DeanCare Setting Facility Modifier None Typical Low $41.69 Median $50.12 Typical High $89.13 | Facility | None | $41.69 | $50.12 | $89.13 |
DeanCare Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $112.20 | Professional | None | $63.10 | $79.43 | $112.20 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $63.10 Typical High $263.03 | Facility | None | $41.69 | $63.10 | $263.03 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $288.40 | Professional | None | $41.69 | $57.54 | $288.40 |
Network Health Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $74.13 | Facility | None | $57.54 | $57.54 | $74.13 |
Network Health Setting Professional Modifier None Typical Low $33.11 Median $85.11 Typical High $114.82 | Professional | None | $33.11 | $85.11 | $114.82 |
Prevea360 Setting Facility Modifier None Typical Low $41.69 Median $50.12 Typical High $89.13 | Facility | None | $41.69 | $50.12 | $89.13 |
Quartz Setting Professional Modifier None Typical Low $32.36 Median $51.29 Typical High $123.03 | Professional | None | $32.36 | $51.29 | $123.03 |
Quartz Setting Professional Modifier None Typical Low $27.54 Median $33.11 Typical High $53.70 | Professional | None | $27.54 | $33.11 | $53.70 |
Security Health Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | None | $66.07 | $66.07 | $79.43 |
Security Health Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $141.25 | Professional | None | $58.88 | $91.20 | $141.25 |
The Alliance Setting Professional Modifier None Typical Low $44.67 Median $100.00 Typical High $151.36 | Professional | None | $44.67 | $100.00 | $151.36 |
United Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
United Setting Professional Modifier None Typical Low $33.11 Median $44.67 Typical High $134.90 | Professional | None | $33.11 | $44.67 | $134.90 |
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 $19.50 Median $19.50 Typical High $23.44 | Facility | 52 · Reduced service | $19.50 | $19.50 | $23.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $9.33 | Facility | 53 · Discontinued | $7.76 | $7.76 | $9.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $6.92 | Facility | 55 · Aftercare only | $5.75 | $5.75 | $6.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $4.68 | Facility | 56 · Pre-op care only | $3.89 | $3.89 | $4.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $21.38 Typical High $23.44 | Professional | 52 · Reduced service | $19.50 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.51 Typical High $9.33 | Professional | 53 · Discontinued | $7.76 | $8.51 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.46 Typical High $6.92 | Professional | 55 · Aftercare only | $5.75 | $6.46 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.27 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.89 | $4.27 | $4.68 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.00 Median $12.59 Typical High $17.78 | Professional | 80 · Assistant surgeon | $10.00 | $12.59 | $17.78 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.00 Median $12.59 Typical High $17.78 | Professional | 81 · Minimal assistant surgeon | $10.00 | $12.59 | $17.78 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.00 Median $12.59 Typical High $17.78 | Professional | 82 · Assistant surgeon, no resident | $10.00 | $12.59 | $17.78 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $8.71 Median $10.96 Typical High $15.49 | Professional | AS · PA/NP assist | $8.71 | $10.96 | $15.49 |
Where Wisconsin sits
The same service costs 2.9 times more in Alaska than in Kentucky. 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
$45.71
AK $100KY $34.67
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.