How much rates vary
Facilitymedian $55 · 10th to 90th $34 to $195Professionalmedian $79 · 10th to 90th $40 to $186
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 $29.51 Median $45.71 Typical High $61.66 | Facility | None | $29.51 | $45.71 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $45.71 Typical High $74.13 | Professional | None | $29.51 | $45.71 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $97.72 Typical High $177.83 | Professional | None | $56.23 | $97.72 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $100.00 | Professional | None | $64.57 | $85.11 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $218.78 Typical High $331.13 | Facility | None | $194.98 | $218.78 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $165.96 | Professional | None | $51.29 | $79.43 | $165.96 |
DeanCare Setting Facility Modifier None Typical Low $42.66 Median $63.10 Typical High $147.91 | Facility | None | $42.66 | $63.10 | $147.91 |
DeanCare Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $151.36 | Professional | None | $70.79 | $104.71 | $151.36 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $120.23 Typical High $181.97 | Facility | None | $51.29 | $120.23 | $181.97 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $223.87 Typical High $457.09 | Professional | None | $75.86 | $223.87 | $457.09 |
Network Health Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Facility | None | $72.44 | $72.44 | $97.72 |
Network Health Setting Professional Modifier None Typical Low $53.70 Median $91.20 Typical High $147.91 | Professional | None | $53.70 | $91.20 | $147.91 |
Prevea360 Setting Facility Modifier None Typical Low $42.66 Median $63.10 Typical High $147.91 | Facility | None | $42.66 | $63.10 | $147.91 |
Quartz Setting Professional Modifier None Typical Low $52.48 Median $104.71 Typical High $169.82 | Professional | None | $52.48 | $104.71 | $169.82 |
Quartz Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $95.50 | Professional | None | $51.29 | $69.18 | $95.50 |
Security Health Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $85.11 | Professional | None | $57.54 | $57.54 | $85.11 |
Security Health Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $169.82 | Professional | None | $69.18 | $102.33 | $169.82 |
The Alliance Setting Professional Modifier None Typical Low $61.66 Median $117.49 Typical High $177.83 | Professional | None | $61.66 | $117.49 | $177.83 |
United Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $177.83 | Professional | None | $53.70 | $83.18 | $177.83 |
10 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 $19.95 Median $22.91 Typical High $30.90 | Facility | 52 · Reduced service | $19.95 | $22.91 | $30.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.03 Median $6.92 Typical High $9.12 | Facility | 55 · Aftercare only | $6.03 | $6.92 | $9.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.57 Typical High $6.17 | Facility | 56 · Pre-op care only | $3.98 | $4.57 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $30.90 Typical High $35.48 | Professional | 52 · Reduced service | $19.95 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.12 Typical High $10.72 | Professional | 55 · Aftercare only | $6.03 | $9.12 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.17 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.98 | $6.17 | $7.08 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.22 Median $16.60 Typical High $23.99 | Professional | 80 · Assistant surgeon | $11.22 | $16.60 | $23.99 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.22 Median $16.60 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $11.22 | $16.60 | $23.99 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.22 Median $16.60 Typical High $23.99 | Professional | 82 · Assistant surgeon, no resident | $11.22 | $16.60 | $23.99 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $9.77 Median $14.79 Typical High $20.89 | Professional | AS · PA/NP assist | $9.77 | $14.79 | $20.89 |
Where Wisconsin sits
The same service costs 2.2 times more in Alaska 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.
Wisconsin· 12th of 51
$79.43
AK $107NJ $48.98
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.