How much rates vary
Facilitymedian $49 · 10th to 90th $26 to $138Professionalmedian $65 · 10th to 90th $27 to $145
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 $25.70 Median $36.31 Typical High $45.71 | Facility | None | $25.70 | $36.31 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $45.71 Typical High $186.21 | Professional | None | $25.70 | $45.71 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $81.28 Typical High $147.91 | Professional | None | $33.88 | $81.28 | $147.91 |
CareSource Setting Professional Modifier None Typical Low $40.74 Median $43.65 Typical High $53.70 | Professional | None | $40.74 | $43.65 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $134.90 Typical High $158.49 | Facility | None | $104.71 | $134.90 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $45.71 Typical High $128.82 | Professional | None | $23.99 | $45.71 | $128.82 |
DeanCare Setting Facility Modifier None Typical Low $26.92 Median $46.77 Typical High $85.11 | Facility | None | $26.92 | $46.77 | $85.11 |
DeanCare Setting Professional Modifier None Typical Low $44.67 Median $74.13 Typical High $102.33 | Professional | None | $44.67 | $74.13 | $102.33 |
Medica Setting Facility Modifier None Typical Low $27.54 Median $50.12 Typical High $309.03 | Facility | None | $27.54 | $50.12 | $309.03 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $158.49 | Professional | None | $38.02 | $48.98 | $158.49 |
Network Health Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Facility | None | $38.02 | $38.02 | $51.29 |
Network Health Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $97.72 | Professional | None | $42.66 | $60.26 | $97.72 |
Prevea360 Setting Facility Modifier None Typical Low $26.92 Median $46.77 Typical High $85.11 | Facility | None | $26.92 | $46.77 | $85.11 |
Quartz Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $131.83 | Professional | None | $46.77 | $75.86 | $131.83 |
Quartz Setting Professional Modifier None Typical Low $23.99 Median $44.67 Typical High $81.28 | Professional | None | $23.99 | $44.67 | $81.28 |
Security Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $51.29 | Professional | None | $30.20 | $30.20 | $51.29 |
Security Health Setting Professional Modifier None Typical Low $45.71 Median $77.62 Typical High $154.88 | Professional | None | $45.71 | $77.62 | $154.88 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $23.44 Median $40.74 Typical High $104.71 | Professional | None | $23.44 | $40.74 | $104.71 |
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 Facility Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $6.92 | Facility | 55 · Aftercare only | $3.89 | $3.89 | $6.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $4.57 | Facility | 56 · Pre-op care only | $2.57 | $2.57 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $6.92 Typical High $28.18 | Professional | 55 · Aftercare only | $3.89 | $6.92 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $4.57 Typical High $18.62 | Professional | 56 · Pre-op care only | $2.57 | $4.57 | $18.62 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.08 Median $12.02 Typical High $16.22 | Professional | 80 · Assistant surgeon | $7.08 | $12.02 | $16.22 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.08 Median $12.02 Typical High $16.22 | Professional | 81 · Minimal assistant surgeon | $7.08 | $12.02 | $16.22 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.08 Median $12.02 Typical High $16.22 | Professional | 82 · Assistant surgeon, no resident | $7.08 | $12.02 | $16.22 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $6.17 Median $10.47 Typical High $14.13 | Professional | AS · PA/NP assist | $6.17 | $10.47 | $14.13 |
Where Wisconsin sits
The same service costs 86.3 times more in Connecticut than in New Jersey. 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.
Physician feeFacility fee
CT $4,814NJ $55.76
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.