How much rates vary
Facilitymedian $38 · 10th to 90th $30 to $98Professionalmedian $42 · 10th to 90th $30 to $117
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 $32.36 Median $32.36 Typical High $38.02 | Facility | None | $32.36 | $32.36 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $46.77 | Professional | None | $32.36 | $38.02 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.18 Median $41.69 Typical High $104.71 | Professional | None | $28.18 | $41.69 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $97.72 Typical High $147.91 | Facility | None | $87.10 | $97.72 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $67.61 | Professional | None | $29.51 | $29.51 | $67.61 |
DeanCare Setting Facility Modifier None Typical Low $28.84 Median $33.88 Typical High $57.54 | Facility | None | $28.84 | $33.88 | $57.54 |
DeanCare Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $72.44 | Professional | None | $38.90 | $57.54 | $72.44 |
Medica Setting Facility Modifier None Typical Low $28.84 Median $33.11 Typical High $57.54 | Facility | None | $28.84 | $33.11 | $57.54 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $173.78 Typical High $199.53 | Professional | None | $33.11 | $173.78 | $199.53 |
Network Health Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Network Health Setting Professional Modifier None Typical Low $30.90 Median $61.66 Typical High $70.79 | Professional | None | $30.90 | $61.66 | $70.79 |
Prevea360 Setting Facility Modifier None Typical Low $28.84 Median $33.88 Typical High $57.54 | Facility | None | $28.84 | $33.88 | $57.54 |
Prevea360 Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Quartz Setting Professional Modifier None Typical Low $27.54 Median $51.29 Typical High $87.10 | Professional | None | $27.54 | $51.29 | $87.10 |
Quartz Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $33.11 | Professional | None | $29.51 | $29.51 | $33.11 |
Security Health Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $38.90 | Professional | None | $33.88 | $33.88 | $38.90 |
Security Health Setting Professional Modifier None Typical Low $20.89 Median $57.54 Typical High $97.72 | Professional | None | $20.89 | $57.54 | $97.72 |
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 $27.54 Median $44.67 Typical High $109.65 | Professional | None | $27.54 | $44.67 | $109.65 |
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 $16.22 Median $16.22 Typical High $19.05 | Facility | 52 · Reduced service | $16.22 | $16.22 | $19.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $7.59 | Facility | 53 · Discontinued | $6.61 | $6.61 | $7.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.75 | Facility | 55 · Aftercare only | $4.90 | $4.90 | $5.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.80 | Facility | 56 · Pre-op care only | $3.24 | $3.24 | $3.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $19.05 Typical High $22.39 | Professional | 52 · Reduced service | $16.22 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.59 Typical High $8.91 | Professional | 53 · Discontinued | $6.61 | $7.59 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.75 Typical High $6.76 | Professional | 55 · Aftercare only | $4.90 | $5.75 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.80 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.24 | $3.80 | $4.47 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.31 Median $9.33 Typical High $11.48 | Professional | 80 · Assistant surgeon | $6.31 | $9.33 | $11.48 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.31 Median $9.33 Typical High $11.48 | Professional | 81 · Minimal assistant surgeon | $6.31 | $9.33 | $11.48 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.31 Median $9.33 Typical High $11.48 | Professional | 82 · Assistant surgeon, no resident | $6.31 | $9.33 | $11.48 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $5.50 Median $8.13 Typical High $10.00 | Professional | AS · PA/NP assist | $5.50 | $8.13 | $10.00 |
Where Wisconsin sits
The same service costs 3.8 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
$41.69
AK $74.13IN $19.50
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.