How much rates vary
Facilitymedian $141 · 10th to 90th $95 to $447Professionalmedian $186 · 10th to 90th $107 to $437
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 $85.11 Median $112.20 Typical High $141.25 | Facility | None | $85.11 | $112.20 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $181.97 | Professional | None | $85.11 | $112.20 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $416.87 | Professional | None | $154.88 | $239.88 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $234.42 | Professional | None | $154.88 | $199.53 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $501.19 Typical High $758.58 | Facility | None | $446.68 | $501.19 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $380.19 | Professional | None | $134.90 | $186.21 | $380.19 |
DeanCare Setting Facility Modifier None Typical Low $117.49 Median $154.88 Typical High $316.23 | Facility | None | $117.49 | $154.88 | $316.23 |
DeanCare Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $346.74 | Professional | None | $199.53 | $275.42 | $346.74 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $186.21 Typical High $389.05 | Facility | None | $117.49 | $186.21 | $389.05 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $446.68 Typical High $1,047.13 | Professional | None | $177.83 | $446.68 | $1,047.13 |
Network Health Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $257.04 | Facility | None | $199.53 | $199.53 | $257.04 |
Network Health Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $338.84 | Professional | None | $123.03 | $234.42 | $338.84 |
Prevea360 Setting Facility Modifier None Typical Low $117.49 Median $154.88 Typical High $316.23 | Facility | None | $117.49 | $154.88 | $316.23 |
Quartz Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $407.38 | Professional | None | $147.91 | $275.42 | $407.38 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $223.87 | Professional | None | $131.83 | $158.49 | $223.87 |
Security Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $194.98 | Professional | None | $158.49 | $158.49 | $194.98 |
Security Health Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $371.54 | Professional | None | $173.78 | $239.88 | $371.54 |
The Alliance Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $398.11 | Professional | None | $165.96 | $263.03 | $398.11 |
United Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $398.11 | Professional | None | $138.04 | $208.93 | $398.11 |
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 $56.23 Median $63.10 Typical High $70.79 | Facility | 52 · Reduced service | $56.23 | $63.10 | $70.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $19.05 Typical High $21.38 | Facility | 55 · Aftercare only | $16.98 | $19.05 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.59 Typical High $14.13 | Facility | 56 · Pre-op care only | $11.22 | $12.59 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $70.79 Typical High $81.28 | Professional | 52 · Reduced service | $56.23 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $21.38 Typical High $24.55 | Professional | 55 · Aftercare only | $16.98 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.13 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.22 | $14.13 | $16.22 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $32.36 Median $44.67 Typical High $56.23 | Professional | 80 · Assistant surgeon | $32.36 | $44.67 | $56.23 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $32.36 Median $44.67 Typical High $56.23 | Professional | 81 · Minimal assistant surgeon | $32.36 | $44.67 | $56.23 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $32.36 Median $44.67 Typical High $56.23 | Professional | 82 · Assistant surgeon, no resident | $32.36 | $44.67 | $56.23 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $38.90 Typical High $48.98 | Professional | AS · PA/NP assist | $28.18 | $38.90 | $48.98 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $234.42 Median $398.11 Typical High $489.78 | Professional | 25 · Same-day visit | $234.42 | $398.11 | $489.78 |
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
$186
AK $263AL $115
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.