How much rates vary
Facilitymedian $10 · 10th to 90th $5 to $20Professionalmedian $5 · 10th to 90th $4 to $15
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 $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.37 | Professional | None | $4.68 | $4.68 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.47 Median $4.90 Typical High $12.88 | Professional | None | $4.47 | $4.90 | $12.88 |
CareSource Setting Professional Modifier None Typical Low $3.55 Median $5.13 Typical High $5.62 | Professional | None | $3.55 | $5.13 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $13.18 Typical High $19.95 | Facility | None | $11.75 | $13.18 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $7.76 Typical High $9.77 | Professional | None | $3.02 | $7.76 | $9.77 |
DeanCare Setting Facility Modifier None Typical Low $4.17 Median $5.25 Typical High $10.00 | Facility | None | $4.17 | $5.25 | $10.00 |
DeanCare Setting Professional Modifier None Typical Low $5.25 Median $5.89 Typical High $6.92 | Professional | None | $5.25 | $5.89 | $6.92 |
Medica Setting Facility Modifier None Typical Low $4.17 Median $6.03 Typical High $100.00 | Facility | None | $4.17 | $6.03 | $100.00 |
Medica Setting Professional Modifier None Typical Low $7.59 Median $29.51 Typical High $29.51 | Professional | None | $7.59 | $29.51 | $29.51 |
Network Health Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Network Health Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $4.57 | Professional | None | $3.31 | $3.31 | $4.57 |
Prevea360 Setting Facility Modifier None Typical Low $4.17 Median $5.25 Typical High $10.00 | Facility | None | $4.17 | $5.25 | $10.00 |
Quartz Setting Professional Modifier None Typical Low $5.62 Median $6.61 Typical High $11.22 | Professional | None | $5.62 | $6.61 | $11.22 |
Quartz Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $5.50 | Professional | None | $3.02 | $3.98 | $5.50 |
Security Health Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Security Health Setting Professional Modifier None Typical Low $4.68 Median $7.94 Typical High $26.92 | Professional | None | $4.68 | $7.94 | $26.92 |
The Alliance Setting Professional Modifier None Typical Low $3.63 Median $3.98 Typical High $12.59 | Professional | None | $3.63 | $3.98 | $12.59 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $5.01 Median $8.91 Typical High $19.50 | Professional | None | $5.01 | $8.91 | $19.50 |
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 $2.29 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $0.93 Typical High $0.93 | Professional | 53 · Discontinued | $0.93 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.69 Median $0.69 Typical High $0.69 | Professional | 55 · Aftercare only | $0.69 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.46 | $0.46 | $0.46 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.83 Median $0.93 Typical High $1.10 | Professional | 80 · Assistant surgeon | $0.83 | $0.93 | $1.10 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.83 Median $0.93 Typical High $1.10 | Professional | 81 · Minimal assistant surgeon | $0.83 | $0.93 | $1.10 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.83 Median $0.93 Typical High $1.10 | Professional | 82 · Assistant surgeon, no resident | $0.83 | $0.93 | $1.10 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $0.72 Median $0.81 Typical High $0.95 | Professional | AS · PA/NP assist | $0.72 | $0.81 | $0.95 |
Where Wisconsin sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 23rd of 51
$5.37
ND $8.71NM $3.24
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.