How much rates vary
Facilitymedian $174 · 10th to 90th $132 to $398Professionalmedian $178 · 10th to 90th $120 to $490
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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $512.86 | Professional | None | $131.83 | $131.83 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $436.52 | Professional | None | $120.23 | $177.83 | $436.52 |
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 $154.88 Median $194.98 Typical High $371.54 | Professional | None | $154.88 | $194.98 | $371.54 |
DeanCare Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $263.03 | Facility | None | $117.49 | $151.36 | $263.03 |
DeanCare Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $302.00 | Professional | None | $199.53 | $229.09 | $302.00 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $263.03 | Facility | None | $117.49 | $141.25 | $263.03 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $275.42 Typical High $776.25 | Professional | None | $131.83 | $275.42 | $776.25 |
Network Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $239.88 | Facility | None | $190.55 | $190.55 | $239.88 |
Network Health Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $323.59 | Professional | None | $112.20 | $138.04 | $323.59 |
Prevea360 Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $263.03 | Facility | None | $117.49 | $151.36 | $263.03 |
Quartz Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $426.58 | Professional | None | $134.90 | $257.04 | $426.58 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $186.21 | Professional | None | $117.49 | $154.88 | $186.21 |
Security Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Security Health Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $758.58 | Professional | None | $269.15 | $354.81 | $758.58 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $549.54 | Professional | None | $123.03 | $194.98 | $549.54 |
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 $66.07 Median $66.07 Typical High $251.19 | Professional | 52 · Reduced service | $66.07 | $66.07 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $102.33 | Professional | 53 · Discontinued | $26.30 | $26.30 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $75.86 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $51.29 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $51.29 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $36.31 Typical High $47.86 | Professional | 80 · Assistant surgeon | $31.62 | $36.31 | $47.86 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $36.31 Typical High $47.86 | Professional | 81 · Minimal assistant surgeon | $31.62 | $36.31 | $47.86 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $36.31 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $36.31 | $47.86 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $31.62 Typical High $42.66 | Professional | AS · PA/NP assist | $27.54 | $31.62 | $42.66 |
Where Wisconsin sits
The same service costs 2.8 times more in Alaska than in Indiana. 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· 8th of 51
$178
AK $269IN $95.50
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.