How much rates vary
Facilitymedian $48 · 10th to 90th $25 to $186Professionalmedian $55 · 10th to 90th $30 to $132
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 $22.39 Median $36.31 Typical High $47.86 | Facility | None | $22.39 | $36.31 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $36.31 Typical High $51.29 | Professional | None | $22.39 | $36.31 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $67.61 Typical High $131.83 | Professional | None | $37.15 | $67.61 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $79.43 | Professional | None | $51.29 | $66.07 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $173.78 Typical High $257.04 | Facility | None | $151.36 | $173.78 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $63.10 Typical High $120.23 | Professional | None | $37.15 | $63.10 | $120.23 |
DeanCare Setting Facility Modifier None Typical Low $31.62 Median $50.12 Typical High $87.10 | Facility | None | $31.62 | $50.12 | $87.10 |
DeanCare Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $117.49 | Professional | None | $52.48 | $83.18 | $117.49 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $141.25 Typical High $309.03 | Facility | None | $38.90 | $141.25 | $309.03 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $144.54 Typical High $354.81 | Professional | None | $52.48 | $144.54 | $354.81 |
Network Health Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $52.48 | Facility | None | $48.98 | $48.98 | $52.48 |
Network Health Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $87.10 | Professional | None | $41.69 | $57.54 | $87.10 |
Prevea360 Setting Facility Modifier None Typical Low $31.62 Median $50.12 Typical High $87.10 | Facility | None | $31.62 | $50.12 | $87.10 |
Quartz Setting Professional Modifier None Typical Low $38.90 Median $75.86 Typical High $134.90 | Professional | None | $38.90 | $75.86 | $134.90 |
Quartz Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $69.18 | Professional | None | $37.15 | $45.71 | $69.18 |
Security Health Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $66.07 | Professional | None | $42.66 | $42.66 | $66.07 |
Security Health Setting Professional Modifier None Typical Low $38.02 Median $67.61 Typical High $117.49 | Professional | None | $38.02 | $67.61 | $117.49 |
The Alliance Setting Professional Modifier None Typical Low $39.81 Median $69.18 Typical High $120.23 | Professional | None | $39.81 | $69.18 | $120.23 |
United Setting Professional Modifier None Typical Low $29.51 Median $56.23 Typical High $104.71 | Professional | None | $29.51 | $56.23 | $104.71 |
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 $14.79 Median $16.98 Typical High $23.99 | Facility | 52 · Reduced service | $14.79 | $16.98 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.47 Median $5.13 Typical High $7.24 | Facility | 55 · Aftercare only | $4.47 | $5.13 | $7.24 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.39 Typical High $4.79 | Facility | 56 · Pre-op care only | $3.02 | $3.39 | $4.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $23.99 Typical High $26.30 | Professional | 52 · Reduced service | $14.79 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $7.08 Typical High $7.94 | Professional | 55 · Aftercare only | $4.47 | $7.08 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $4.79 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.02 | $4.79 | $5.25 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.51 Median $13.18 Typical High $19.05 | Professional | 80 · Assistant surgeon | $8.51 | $13.18 | $19.05 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.51 Median $13.18 Typical High $19.05 | Professional | 81 · Minimal assistant surgeon | $8.51 | $13.18 | $19.05 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.51 Median $13.18 Typical High $19.05 | Professional | 82 · Assistant surgeon, no resident | $8.51 | $13.18 | $19.05 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $7.41 Median $11.48 Typical High $16.60 | Professional | AS · PA/NP assist | $7.41 | $11.48 | $16.60 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $85.11 Median $107.15 Typical High $144.54 | Professional | 25 · Same-day visit | $85.11 | $107.15 | $144.54 |
Where Wisconsin sits
The same service costs 2.4 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
$54.95
AK $77.62NJ $32.36
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.