How much rates vary
Facilitymedian $95 · 10th to 90th $43 to $288Professionalmedian $78 · 10th to 90th $43 to $661
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 $77.62 Median $77.62 Typical High $97.72 | Facility | None | $77.62 | $77.62 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $77.62 Typical High $87.10 | Professional | None | $45.71 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $11.75 Typical High $12.88 | Professional | 55 · Aftercare only | $8.32 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.62 | $7.76 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $44.67 Median $47.86 Typical High $53.70 | Facility | None | $44.67 | $47.86 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $707.95 | Professional | None | $54.95 | $91.20 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $125.89 Typical High $288.40 | Facility | None | $75.86 | $125.89 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $93.33 Typical High $112.20 | Professional | None | $48.98 | $93.33 | $112.20 |
DeanCare Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $112.20 | Facility | None | $60.26 | $81.28 | $112.20 |
DeanCare Setting Professional Modifier None Typical Low $58.88 Median $151.36 Typical High $181.97 | Professional | None | $58.88 | $151.36 | $181.97 |
Medica Setting Facility Modifier None Typical Low $22.91 Median $42.66 Typical High $120.23 | Facility | None | $22.91 | $42.66 | $120.23 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $660.69 | Professional | None | $42.66 | $53.70 | $660.69 |
Network Health Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $25.12 | Facility | None | $22.39 | $22.39 | $25.12 |
Network Health Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $83.18 | Professional | None | $64.57 | $64.57 | $83.18 |
Prevea360 Setting Facility Modifier None Typical Low $42.66 Median $60.26 Typical High $457.09 | Facility | None | $42.66 | $60.26 | $457.09 |
Quartz Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $371.54 | Professional | None | $128.82 | $245.47 | $371.54 |
Quartz Setting Facility Modifier None Typical Low $125.89 Median $288.40 Typical High $288.40 | Facility | None | $125.89 | $288.40 | $288.40 |
Quartz Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Security Health Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $35.48 | Professional | None | $30.90 | $30.90 | $35.48 |
United Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $56.23 | Professional | None | $42.66 | $42.66 | $56.23 |
8 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 |
|---|---|---|---|---|---|
DeanCare Setting Facility Modifier 80 · Assistant surgeon Typical Low $10.47 Median $12.88 Typical High $16.22 | Facility | 80 · Assistant surgeon | $10.47 | $12.88 | $16.22 |
DeanCare Setting Facility Modifier 81 · Minimal assistant surgeon Typical Low $10.47 Median $12.88 Typical High $16.22 | Facility | 81 · Minimal assistant surgeon | $10.47 | $12.88 | $16.22 |
DeanCare Setting Facility Modifier 82 · Assistant surgeon, no resident Typical Low $10.47 Median $12.88 Typical High $16.22 | Facility | 82 · Assistant surgeon, no resident | $10.47 | $12.88 | $16.22 |
DeanCare Setting Facility Modifier AS · PA/NP assist Typical Low $9.12 Median $11.22 Typical High $14.13 | Facility | AS · PA/NP assist | $9.12 | $11.22 | $14.13 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.33 Median $23.99 Typical High $28.84 | Professional | 80 · Assistant surgeon | $9.33 | $23.99 | $28.84 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.33 Median $23.99 Typical High $28.84 | Professional | 81 · Minimal assistant surgeon | $9.33 | $23.99 | $28.84 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.33 Median $23.99 Typical High $28.84 | Professional | 82 · Assistant surgeon, no resident | $9.33 | $23.99 | $28.84 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $8.32 Median $20.89 Typical High $25.70 | Professional | AS · PA/NP assist | $8.32 | $20.89 | $25.70 |
Where Wisconsin sits
The same service costs 2.6 times more in Texas than in Connecticut. 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
$77.62
TX $93.33CT $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.