How much rates vary
Facilitymedian $132 · 10th to 90th $89 to $417Professionalmedian $186 · 10th to 90th $100 to $427
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 $89.13 Median $100.00 Typical High $125.89 | Facility | None | $89.13 | $100.00 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $707.95 | Professional | None | $89.13 | $100.00 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $338.84 | Professional | None | $125.89 | $208.93 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $169.82 | Professional | None | $109.65 | $112.20 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $354.81 Typical High $524.81 | Facility | None | $309.03 | $354.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $302.00 | Professional | None | $117.49 | $131.83 | $302.00 |
DeanCare Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $239.88 | Facility | None | $97.72 | $125.89 | $239.88 |
DeanCare Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $288.40 | Professional | None | $186.21 | $218.78 | $288.40 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $141.25 Typical High $794.33 | Facility | None | $97.72 | $141.25 | $794.33 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $676.08 Typical High $1,174.90 | Professional | None | $158.49 | $676.08 | $1,174.90 |
Network Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $218.78 | Facility | None | $162.18 | $162.18 | $218.78 |
Network Health Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $288.40 | Professional | None | $109.65 | $204.17 | $288.40 |
Prevea360 Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $239.88 | Facility | None | $97.72 | $125.89 | $239.88 |
Quartz Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $354.81 | Professional | None | $151.36 | $263.03 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $162.18 | Professional | None | $117.49 | $131.83 | $162.18 |
Security Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | None | $181.97 | $181.97 | $204.17 |
Security Health Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $416.87 | Professional | None | $186.21 | $331.13 | $416.87 |
The Alliance Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $426.58 | Professional | None | $141.25 | $245.47 | $426.58 |
United Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $316.23 | Professional | None | $123.03 | $181.97 | $316.23 |
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 $44.67 Median $44.67 Typical High $50.12 | Facility | 52 · Reduced service | $44.67 | $44.67 | $50.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $15.14 | Facility | 55 · Aftercare only | $13.49 | $13.49 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $10.00 | Facility | 56 · Pre-op care only | $8.91 | $8.91 | $10.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $50.12 Typical High $446.68 | Professional | 52 · Reduced service | $44.67 | $50.12 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $134.90 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.00 Typical High $89.13 | Professional | 56 · Pre-op care only | $8.91 | $10.00 | $89.13 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $29.51 Median $34.67 Typical High $45.71 | Professional | 80 · Assistant surgeon | $29.51 | $34.67 | $45.71 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $29.51 Median $34.67 Typical High $45.71 | Professional | 81 · Minimal assistant surgeon | $29.51 | $34.67 | $45.71 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $29.51 Median $34.67 Typical High $45.71 | Professional | 82 · Assistant surgeon, no resident | $29.51 | $34.67 | $45.71 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $25.70 Median $30.20 Typical High $39.81 | Professional | AS · PA/NP assist | $25.70 | $30.20 | $39.81 |
Where Wisconsin sits
The same service costs 2.7 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· 10th of 51
$186
AK $263NJ $97.72
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.