How much rates vary
Facilitymedian $95 · 10th to 90th $59 to $295Professionalmedian $123 · 10th to 90th $69 to $288
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 $51.29 Median $70.79 Typical High $95.50 | Facility | None | $51.29 | $70.79 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $117.49 | Professional | None | $51.29 | $70.79 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $275.42 | Professional | None | $95.50 | $158.49 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $158.49 | Professional | None | $102.33 | $131.83 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $338.84 Typical High $501.19 | Facility | None | $295.12 | $338.84 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $251.19 | Professional | None | $89.13 | $123.03 | $251.19 |
DeanCare Setting Facility Modifier None Typical Low $72.44 Median $97.72 Typical High $208.93 | Facility | None | $72.44 | $97.72 | $208.93 |
DeanCare Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $234.42 | Professional | None | $123.03 | $169.82 | $234.42 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $173.78 Typical High $245.47 | Facility | None | $74.13 | $173.78 | $245.47 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $295.12 Typical High $691.83 | Professional | None | $117.49 | $295.12 | $691.83 |
Network Health Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $151.36 | Facility | None | $123.03 | $123.03 | $151.36 |
Network Health Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $218.78 | Professional | None | $83.18 | $138.04 | $218.78 |
Prevea360 Setting Facility Modifier None Typical Low $72.44 Median $97.72 Typical High $208.93 | Facility | None | $72.44 | $97.72 | $208.93 |
Quartz Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $269.15 | Professional | None | $89.13 | $169.82 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $147.91 | Professional | None | $89.13 | $107.15 | $147.91 |
Security Health Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | None | $97.72 | $97.72 | $131.83 |
Security Health Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $245.47 | Professional | None | $104.71 | $162.18 | $245.47 |
The Alliance Setting Professional Modifier None Typical Low $100.00 Median $177.83 Typical High $257.04 | Professional | None | $100.00 | $177.83 | $257.04 |
United Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $251.19 | Professional | None | $83.18 | $123.03 | $251.19 |
11 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 $34.67 Median $38.90 Typical High $47.86 | Facility | 52 · Reduced service | $34.67 | $38.90 | $47.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $11.75 Typical High $14.13 | Facility | 55 · Aftercare only | $10.23 | $11.75 | $14.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.76 Typical High $9.55 | Facility | 56 · Pre-op care only | $6.92 | $7.76 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $47.86 Typical High $53.70 | Professional | 52 · Reduced service | $34.67 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $14.13 Typical High $15.85 | Professional | 55 · Aftercare only | $10.23 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $9.55 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.92 | $9.55 | $10.72 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $26.92 Typical High $37.15 | Professional | 80 · Assistant surgeon | $19.50 | $26.92 | $37.15 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $26.92 Typical High $37.15 | Professional | 81 · Minimal assistant surgeon | $19.50 | $26.92 | $37.15 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $26.92 Typical High $37.15 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $26.92 | $37.15 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $23.44 Typical High $32.36 | Professional | AS · PA/NP assist | $17.38 | $23.44 | $32.36 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $181.97 Median $257.04 Typical High $331.13 | Professional | 25 · Same-day visit | $181.97 | $257.04 | $331.13 |
Where Wisconsin sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 14th of 51
$123
AK $170AL $74.13
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.