How much rates vary
Facilitymedian $43 · 10th to 90th $31 to $115Professionalmedian $83 · 10th to 90th $37 to $170
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 $30.90 Median $30.90 Typical High $32.36 | Facility | None | $30.90 | $30.90 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $309.03 | Professional | None | $30.90 | $32.36 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $151.36 | Professional | None | $50.12 | $89.13 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $114.82 Typical High $169.82 | Facility | None | $100.00 | $114.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $125.89 | Professional | None | $40.74 | $57.54 | $125.89 |
DeanCare Setting Facility Modifier None Typical Low $35.48 Median $42.66 Typical High $77.62 | Facility | None | $35.48 | $42.66 | $77.62 |
DeanCare Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $107.15 | Professional | None | $70.79 | $79.43 | $107.15 |
Medica Setting Facility Modifier None Typical Low $35.48 Median $42.66 Typical High $77.62 | Facility | None | $35.48 | $42.66 | $77.62 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $141.25 Typical High $331.13 | Professional | None | $60.26 | $141.25 | $331.13 |
Network Health Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Network Health Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $112.20 | Professional | None | $74.13 | $97.72 | $112.20 |
Prevea360 Setting Facility Modifier None Typical Low $35.48 Median $42.66 Typical High $77.62 | Facility | None | $35.48 | $42.66 | $77.62 |
Quartz Setting Professional Modifier None Typical Low $43.65 Median $85.11 Typical High $120.23 | Professional | None | $43.65 | $85.11 | $120.23 |
Quartz Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $70.79 | Professional | None | $40.74 | $42.66 | $70.79 |
Security Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Security Health Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $95.50 | Professional | None | $66.07 | $77.62 | $95.50 |
The Alliance Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $173.78 | Professional | None | $131.83 | $131.83 | $173.78 |
United Setting Professional Modifier None Typical Low $46.77 Median $89.13 Typical High $147.91 | Professional | None | $46.77 | $89.13 | $147.91 |
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 $15.49 Median $15.49 Typical High $16.22 | Facility | 52 · Reduced service | $15.49 | $15.49 | $16.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.90 | Facility | 55 · Aftercare only | $4.68 | $4.68 | $4.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.24 | Facility | 56 · Pre-op care only | $3.09 | $3.09 | $3.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $16.22 Typical High $154.88 | Professional | 52 · Reduced service | $15.49 | $16.22 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.90 Typical High $46.77 | Professional | 55 · Aftercare only | $4.68 | $4.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.24 Typical High $30.90 | Professional | 56 · Pre-op care only | $3.09 | $3.24 | $30.90 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.22 Median $12.59 Typical High $17.38 | Professional | 80 · Assistant surgeon | $11.22 | $12.59 | $17.38 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.22 Median $12.59 Typical High $17.38 | Professional | 81 · Minimal assistant surgeon | $11.22 | $12.59 | $17.38 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.22 Median $12.59 Typical High $17.38 | Professional | 82 · Assistant surgeon, no resident | $11.22 | $12.59 | $17.38 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $10.00 Median $10.96 Typical High $15.14 | Professional | AS · PA/NP assist | $10.00 | $10.96 | $15.14 |
Where Wisconsin sits
The same service costs 2.6 times more in Nebraska than in Texas. 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· 3rd of 51
$83.18
NE $93.33TX $36.31
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.