How much rates vary
Facilitymedian $47 · 10th to 90th $27 to $120Professionalmedian $54 · 10th to 90th $25 to $229
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 $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $218.78 | Professional | None | $26.92 | $26.92 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $50.12 Typical High $199.53 | Professional | None | $25.12 | $50.12 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $81.28 Typical High $120.23 | Facility | None | $70.79 | $81.28 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $44.67 Typical High $89.13 | Professional | None | $38.90 | $44.67 | $89.13 |
DeanCare Setting Facility Modifier None Typical Low $23.99 Median $30.90 Typical High $56.23 | Facility | None | $23.99 | $30.90 | $56.23 |
DeanCare Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $72.44 | Professional | None | $47.86 | $54.95 | $72.44 |
Medica Setting Facility Modifier None Typical Low $23.99 Median $35.48 Typical High $331.13 | Facility | None | $23.99 | $35.48 | $331.13 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $100.00 Typical High $239.88 | Professional | None | $31.62 | $100.00 | $239.88 |
Network Health Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $50.12 | Facility | None | $40.74 | $40.74 | $50.12 |
Network Health Setting Professional Modifier None Typical Low $22.91 Median $28.84 Typical High $61.66 | Professional | None | $22.91 | $28.84 | $61.66 |
Prevea360 Setting Facility Modifier None Typical Low $23.99 Median $30.90 Typical High $56.23 | Facility | None | $23.99 | $30.90 | $56.23 |
Quartz Setting Professional Modifier None Typical Low $30.20 Median $60.26 Typical High $89.13 | Professional | None | $30.20 | $60.26 | $89.13 |
Quartz Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $56.23 | Professional | None | $38.90 | $38.90 | $56.23 |
Security Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Security Health Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $234.42 | Professional | None | $75.86 | $97.72 | $234.42 |
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 $27.54 Median $53.70 Typical High $100.00 | Professional | None | $27.54 | $53.70 | $100.00 |
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 $13.49 Median $13.49 Typical High $109.65 | Professional | 52 · Reduced service | $13.49 | $13.49 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $43.65 | Professional | 53 · Discontinued | $5.37 | $5.37 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $33.11 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $21.88 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $21.88 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.59 Median $8.71 Typical High $11.75 | Professional | 80 · Assistant surgeon | $7.59 | $8.71 | $11.75 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.59 Median $8.71 Typical High $11.75 | Professional | 81 · Minimal assistant surgeon | $7.59 | $8.71 | $11.75 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.59 Median $8.71 Typical High $11.75 | Professional | 82 · Assistant surgeon, no resident | $7.59 | $8.71 | $11.75 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $6.61 Median $7.76 Typical High $10.23 | Professional | AS · PA/NP assist | $6.61 | $7.76 | $10.23 |
Where Wisconsin sits
The same service costs 2.5 times more in Minnesota than in Arkansas. 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· 4th of 51
$53.70
MN $63.10AR $25.70
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.