How much rates vary
Facilitymedian $23 · 10th to 90th $8 to $48Professionalmedian $11 · 10th to 90th $7 to $74
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 $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $199.53 | Professional | None | $7.59 | $7.59 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $41.69 Typical High $46.77 | Facility | None | $38.02 | $41.69 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $19.05 Typical High $61.66 | Professional | None | $11.48 | $19.05 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $12.88 Median $20.42 Typical High $29.51 | Facility | None | $12.88 | $20.42 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $20.89 | Professional | None | $9.77 | $9.77 | $20.89 |
DeanCare Setting Facility Modifier None Typical Low $12.59 Median $43.65 Typical High $58.88 | Facility | None | $12.59 | $43.65 | $58.88 |
DeanCare Setting Professional Modifier None Typical Low $12.59 Median $53.70 Typical High $69.18 | Professional | None | $12.59 | $53.70 | $69.18 |
Medica Setting Facility Modifier None Typical Low $9.33 Median $12.59 Typical High $23.99 | Facility | None | $9.33 | $12.59 | $23.99 |
Medica Setting Professional Modifier None Typical Low $6.92 Median $11.75 Typical High $74.13 | Professional | None | $6.92 | $11.75 | $74.13 |
Network Health Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $23.99 | Facility | None | $21.38 | $21.38 | $23.99 |
Network Health Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $58.88 | Professional | None | $19.05 | $19.05 | $58.88 |
Prevea360 Setting Facility Modifier None Typical Low $9.33 Median $12.59 Typical High $23.99 | Facility | None | $9.33 | $12.59 | $23.99 |
Quartz Setting Professional Modifier None Typical Low $12.59 Median $23.99 Typical High $35.48 | Professional | None | $12.59 | $23.99 | $35.48 |
Quartz Setting Facility Modifier None Typical Low $12.88 Median $29.51 Typical High $29.51 | Facility | None | $12.88 | $29.51 | $29.51 |
Quartz Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $4.68 Median $6.92 Typical High $12.30 | Professional | None | $4.68 | $6.92 | $12.30 |
12 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 Professional Modifier 52 · Reduced service Typical Low $3.80 Median $3.80 Typical High $100.00 | Professional | 52 · Reduced service | $3.80 | $3.80 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $1.51 Typical High $39.81 | Professional | 53 · Discontinued | $1.51 | $1.51 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.12 Typical High $29.51 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.76 Typical High $19.95 | Professional | 56 · Pre-op care only | $0.76 | $0.76 | $19.95 |
DeanCare Setting Facility Modifier 80 · Assistant surgeon Typical Low $6.03 Median $7.59 Typical High $9.55 | Facility | 80 · Assistant surgeon | $6.03 | $7.59 | $9.55 |
DeanCare Setting Facility Modifier 81 · Minimal assistant surgeon Typical Low $6.03 Median $7.59 Typical High $9.55 | Facility | 81 · Minimal assistant surgeon | $6.03 | $7.59 | $9.55 |
DeanCare Setting Facility Modifier 82 · Assistant surgeon, no resident Typical Low $6.03 Median $7.59 Typical High $9.55 | Facility | 82 · Assistant surgeon, no resident | $6.03 | $7.59 | $9.55 |
DeanCare Setting Facility Modifier AS · PA/NP assist Typical Low $5.25 Median $6.61 Typical High $8.32 | Facility | AS · PA/NP assist | $5.25 | $6.61 | $8.32 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.04 Median $8.71 Typical High $11.22 | Professional | 80 · Assistant surgeon | $2.04 | $8.71 | $11.22 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.04 Median $8.71 Typical High $11.22 | Professional | 81 · Minimal assistant surgeon | $2.04 | $8.71 | $11.22 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.04 Median $8.71 Typical High $11.22 | Professional | 82 · Assistant surgeon, no resident | $2.04 | $8.71 | $11.22 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $1.78 Median $7.59 Typical High $9.77 | Professional | AS · PA/NP assist | $1.78 | $7.59 | $9.77 |
Where Wisconsin sits
The same service costs 46.8 times more in New York than in Arkansas. 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
$11.48
NY $324AR $6.92
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.