How much rates vary
Facilitymedian $59 · 10th to 90th $35 to $204Professionalmedian $76 · 10th to 90th $43 to $200
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 $34.67 Median $34.67 Typical High $56.23 | Facility | None | $34.67 | $34.67 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $56.23 Typical High $77.62 | Professional | None | $34.67 | $56.23 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $186.21 | Professional | None | $46.77 | $75.86 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $194.98 Typical High $295.12 | Facility | None | $173.78 | $194.98 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $104.71 | Professional | None | $53.70 | $60.26 | $104.71 |
DeanCare Setting Facility Modifier None Typical Low $36.31 Median $58.88 Typical High $79.43 | Facility | None | $36.31 | $58.88 | $79.43 |
DeanCare Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $134.90 | Professional | None | $69.18 | $93.33 | $134.90 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $60.26 Typical High $331.13 | Facility | None | $36.31 | $60.26 | $331.13 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $257.04 Typical High $407.38 | Professional | None | $75.86 | $257.04 | $407.38 |
Network Health Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Network Health Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $120.23 | Professional | None | $50.12 | $85.11 | $120.23 |
Prevea360 Setting Facility Modifier None Typical Low $36.31 Median $58.88 Typical High $79.43 | Facility | None | $36.31 | $58.88 | $79.43 |
Prevea360 Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Quartz Setting Professional Modifier None Typical Low $46.77 Median $87.10 Typical High $173.78 | Professional | None | $46.77 | $87.10 | $173.78 |
Quartz Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Security Health Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $77.62 | Professional | None | $48.98 | $48.98 | $77.62 |
Security Health Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $194.98 | Professional | None | $66.07 | $100.00 | $194.98 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
United Setting Professional Modifier None Typical Low $48.98 Median $81.28 Typical High $154.88 | Professional | None | $48.98 | $81.28 | $154.88 |
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 $17.38 Median $17.38 Typical High $28.18 | Facility | 52 · Reduced service | $17.38 | $17.38 | $28.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $8.51 | Facility | 55 · Aftercare only | $5.25 | $5.25 | $8.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $5.75 | Facility | 56 · Pre-op care only | $3.47 | $3.47 | $5.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $28.18 Typical High $34.67 | Professional | 52 · Reduced service | $17.38 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $8.51 Typical High $10.23 | Professional | 55 · Aftercare only | $5.25 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.75 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.47 | $5.75 | $6.92 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.22 Median $15.14 Typical High $21.88 | Professional | 80 · Assistant surgeon | $11.22 | $15.14 | $21.88 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.22 Median $15.14 Typical High $21.88 | Professional | 81 · Minimal assistant surgeon | $11.22 | $15.14 | $21.88 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.22 Median $15.14 Typical High $21.88 | Professional | 82 · Assistant surgeon, no resident | $11.22 | $15.14 | $21.88 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $9.77 Median $13.18 Typical High $19.05 | Professional | AS · PA/NP assist | $9.77 | $13.18 | $19.05 |
Where Wisconsin sits
The same service costs 2.3 times more in Alaska than in Kentucky. 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· 9th of 51
$75.86
AK $112KY $47.86
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.