How much rates vary
Facilitymedian $20 · 10th to 90th $16 to $52Professionalmedian $22 · 10th to 90th $16 to $66
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 $18.20 Median $18.20 Typical High $20.42 | Facility | None | $18.20 | $18.20 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $20.42 Typical High $23.99 | Professional | None | $18.20 | $20.42 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.49 Median $21.88 Typical High $54.95 | Professional | None | $15.49 | $21.88 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $52.48 Typical High $77.62 | Facility | None | $45.71 | $52.48 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $38.02 | Professional | None | $15.85 | $15.85 | $38.02 |
DeanCare Setting Facility Modifier None Typical Low $15.85 Median $19.05 Typical High $31.62 | Facility | None | $15.85 | $19.05 | $31.62 |
DeanCare Setting Professional Modifier None Typical Low $21.88 Median $30.90 Typical High $39.81 | Professional | None | $21.88 | $30.90 | $39.81 |
Medica Setting Facility Modifier None Typical Low $15.85 Median $18.62 Typical High $31.62 | Facility | None | $15.85 | $18.62 | $31.62 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $95.50 Typical High $107.15 | Professional | None | $16.98 | $95.50 | $107.15 |
Network Health Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Network Health Setting Professional Modifier None Typical Low $15.85 Median $33.11 Typical High $38.90 | Professional | None | $15.85 | $33.11 | $38.90 |
Prevea360 Setting Facility Modifier None Typical Low $15.85 Median $19.05 Typical High $31.62 | Facility | None | $15.85 | $19.05 | $31.62 |
Prevea360 Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Quartz Setting Professional Modifier None Typical Low $14.79 Median $28.84 Typical High $46.77 | Professional | None | $14.79 | $28.84 | $46.77 |
Quartz Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $18.62 | Professional | None | $15.85 | $15.85 | $18.62 |
Security Health Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $20.89 | Professional | None | $18.62 | $18.62 | $20.89 |
Security Health Setting Professional Modifier None Typical Low $20.89 Median $30.20 Typical High $54.95 | Professional | None | $20.89 | $30.20 | $54.95 |
United Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $15.14 Median $23.99 Typical High $60.26 | Professional | None | $15.14 | $23.99 | $60.26 |
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 $9.12 Median $9.12 Typical High $10.00 | Facility | 52 · Reduced service | $9.12 | $9.12 | $10.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $4.07 | Facility | 53 · Discontinued | $3.63 | $3.63 | $4.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $3.02 | Facility | 55 · Aftercare only | $2.75 | $2.75 | $3.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $2.04 | Facility | 56 · Pre-op care only | $1.82 | $1.82 | $2.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $10.00 Typical High $12.02 | Professional | 52 · Reduced service | $9.12 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.07 Typical High $4.79 | Professional | 53 · Discontinued | $3.63 | $4.07 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.02 Typical High $3.63 | Professional | 55 · Aftercare only | $2.75 | $3.02 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.04 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.82 | $2.04 | $2.40 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.47 Median $5.01 Typical High $6.31 | Professional | 80 · Assistant surgeon | $3.47 | $5.01 | $6.31 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.47 Median $5.01 Typical High $6.31 | Professional | 81 · Minimal assistant surgeon | $3.47 | $5.01 | $6.31 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.47 Median $5.01 Typical High $6.31 | Professional | 82 · Assistant surgeon, no resident | $3.47 | $5.01 | $6.31 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $3.02 Median $4.37 Typical High $5.50 | Professional | AS · PA/NP assist | $3.02 | $4.37 | $5.50 |
Where Wisconsin sits
The same service costs 3.2 times more in Alaska than in New York. 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
$22.39
AK $39.81NY $12.30
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.