How much rates vary
Facilitymedian $18 · 10th to 90th $14 to $49Professionalmedian $21 · 10th to 90th $14 to $60
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $13.80 Median $13.80 Typical High $16.22 | Facility | None | $13.80 | $13.80 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $75.86 | Professional | None | $13.80 | $13.80 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.14 Median $22.39 Typical High $53.70 | Professional | None | $15.14 | $22.39 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $47.86 Typical High $72.44 | Facility | None | $42.66 | $47.86 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $38.02 | Professional | None | $14.79 | $14.79 | $38.02 |
DeanCare Setting Facility Modifier None Typical Low $14.13 Median $17.78 Typical High $32.36 | Facility | None | $14.13 | $17.78 | $32.36 |
DeanCare Setting Professional Modifier None Typical Low $16.60 Median $31.62 Typical High $39.81 | Professional | None | $16.60 | $31.62 | $39.81 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $17.78 Typical High $44.67 | Facility | None | $14.79 | $17.78 | $44.67 |
Medica Setting Professional Modifier None Typical Low $16.22 Median $31.62 Typical High $165.96 | Professional | None | $16.22 | $31.62 | $165.96 |
Network Health Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Network Health Setting Professional Modifier None Typical Low $11.75 Median $37.15 Typical High $37.15 | Professional | None | $11.75 | $37.15 | $37.15 |
Prevea360 Setting Facility Modifier None Typical Low $14.13 Median $17.78 Typical High $32.36 | Facility | None | $14.13 | $17.78 | $32.36 |
Prevea360 Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Quartz Setting Professional Modifier None Typical Low $17.78 Median $33.88 Typical High $44.67 | Professional | None | $17.78 | $33.88 | $44.67 |
Quartz Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Security Health Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Security Health Setting Professional Modifier None Typical Low $22.39 Median $42.66 Typical High $56.23 | Professional | None | $22.39 | $42.66 | $56.23 |
The Alliance Setting Professional Modifier None Typical Low $20.89 Median $25.70 Typical High $35.48 | Professional | None | $20.89 | $25.70 | $35.48 |
United Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
United Setting Professional Modifier None Typical Low $15.49 Median $22.39 Typical High $54.95 | Professional | None | $15.49 | $22.39 | $54.95 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.92 Median $6.92 Typical High $37.15 | Professional | 52 · Reduced service | $6.92 | $6.92 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $15.14 | Professional | 53 · Discontinued | $2.82 | $2.82 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $11.22 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $7.59 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $7.59 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.55 Median $5.01 Typical High $6.31 | Professional | 80 · Assistant surgeon | $3.55 | $5.01 | $6.31 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.55 Median $5.01 Typical High $6.31 | Professional | 81 · Minimal assistant surgeon | $3.55 | $5.01 | $6.31 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.55 Median $5.01 Typical High $6.31 | Professional | 82 · Assistant surgeon, no resident | $3.55 | $5.01 | $6.31 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $3.09 Median $4.37 Typical High $5.62 | Professional | AS · PA/NP assist | $3.09 | $4.37 | $5.62 |
Where Wisconsin sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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
$20.89
AK $38.90LA $13.80
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.