How much rates vary
Facilitymedian $78 · 10th to 90th $20 to $537Professionalmedian $76 · 10th to 90th $23 to $295
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 $19.95 Median $75.86 Typical High $14,454.40 | Facility | None | $19.95 | $75.86 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $75.86 Typical High $85.11 | Professional | None | $19.95 | $75.86 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $74.13 Typical High $257.04 | Professional | None | $25.70 | $74.13 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $257.04 Typical High $389.05 | Facility | None | $229.09 | $257.04 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $74.13 Typical High $117.49 | Professional | None | $29.51 | $74.13 | $117.49 |
DeanCare Setting Facility Modifier None Typical Low $19.95 Median $43.65 Typical High $158.49 | Facility | None | $19.95 | $43.65 | $158.49 |
DeanCare Setting Professional Modifier None Typical Low $38.02 Median $75.86 Typical High $173.78 | Professional | None | $38.02 | $75.86 | $173.78 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $74.13 Typical High $512.86 | Facility | None | $19.95 | $74.13 | $512.86 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $302.00 Typical High $537.03 | Professional | None | $77.62 | $302.00 | $537.03 |
Network Health Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Network Health Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $147.91 | Professional | None | $53.70 | $83.18 | $147.91 |
Prevea360 Setting Facility Modifier None Typical Low $19.95 Median $43.65 Typical High $158.49 | Facility | None | $19.95 | $43.65 | $158.49 |
Prevea360 Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Quartz Setting Professional Modifier None Typical Low $25.12 Median $87.10 Typical High $208.93 | Professional | None | $25.12 | $87.10 | $208.93 |
Quartz Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Security Health Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $102.33 | Professional | None | $26.30 | $26.30 | $102.33 |
Security Health Setting Professional Modifier None Typical Low $35.48 Median $109.65 Typical High $263.03 | Professional | None | $35.48 | $109.65 | $263.03 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $26.92 Median $77.62 Typical High $234.42 | Professional | None | $26.92 | $77.62 | $234.42 |
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 Facility Modifier 52 · Reduced service Typical Low $10.00 Median $10.00 Typical High $38.02 | Facility | 52 · Reduced service | $10.00 | $10.00 | $38.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $15.49 | Facility | 53 · Discontinued | $3.98 | $3.98 | $15.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $11.48 | Facility | 55 · Aftercare only | $3.02 | $3.02 | $11.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $7.59 | Facility | 56 · Pre-op care only | $2.00 | $2.00 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.00 Median $38.02 Typical High $41.69 | Professional | 52 · Reduced service | $10.00 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $15.49 Typical High $16.60 | Professional | 53 · Discontinued | $3.98 | $15.49 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $11.48 Typical High $12.59 | Professional | 55 · Aftercare only | $3.02 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $7.59 Typical High $8.32 | Professional | 56 · Pre-op care only | $2.00 | $7.59 | $8.32 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.03 Median $12.02 Typical High $28.18 | Professional | 80 · Assistant surgeon | $6.03 | $12.02 | $28.18 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.03 Median $12.02 Typical High $28.18 | Professional | 81 · Minimal assistant surgeon | $6.03 | $12.02 | $28.18 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.03 Median $12.02 Typical High $28.18 | Professional | 82 · Assistant surgeon, no resident | $6.03 | $12.02 | $28.18 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $5.37 Median $10.47 Typical High $24.55 | Professional | AS · PA/NP assist | $5.37 | $10.47 | $24.55 |
Where Wisconsin sits
The same service costs 6.5 times more in Alaska than in Indiana. 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 $138IN $21.38
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.