How much rates vary
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 $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $52.48 | Professional | None | $11.75 | $11.75 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $8.71 Typical High $43.65 | Professional | None | $5.89 | $8.71 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $18.62 Typical High $27.54 | Facility | None | $16.22 | $18.62 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.76 Typical High $17.78 | Professional | None | $6.46 | $6.76 | $17.78 |
DeanCare Setting Facility Modifier None Typical Low $5.62 Median $7.08 Typical High $12.88 | Facility | None | $5.62 | $7.08 | $12.88 |
DeanCare Setting Professional Modifier None Typical Low $11.22 Median $12.59 Typical High $16.98 | Professional | None | $11.22 | $12.59 | $16.98 |
Medica Setting Facility Modifier None Typical Low $5.62 Median $7.24 Typical High $63.10 | Facility | None | $5.62 | $7.24 | $63.10 |
Medica Setting Professional Modifier None Typical Low $9.55 Median $25.12 Typical High $97.72 | Professional | None | $9.55 | $25.12 | $97.72 |
Network Health Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Network Health Setting Professional Modifier None Typical Low $5.37 Median $6.76 Typical High $23.44 | Professional | None | $5.37 | $6.76 | $23.44 |
Prevea360 Setting Facility Modifier None Typical Low $5.62 Median $7.08 Typical High $12.88 | Facility | None | $5.62 | $7.08 | $12.88 |
Quartz Setting Professional Modifier None Typical Low $7.41 Median $14.79 Typical High $26.92 | Professional | None | $7.41 | $14.79 | $26.92 |
Quartz Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Security Health Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Security Health Setting Professional Modifier None Typical Low $11.75 Median $15.85 Typical High $21.88 | Professional | None | $11.75 | $15.85 | $21.88 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $8.71 Median $17.78 Typical High $34.67 | Professional | None | $8.71 | $17.78 | $34.67 |
4 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 |
|---|---|---|---|---|---|
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.78 Median $2.00 Typical High $2.69 | Professional | 80 · Assistant surgeon | $1.78 | $2.00 | $2.69 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.78 Median $2.00 Typical High $2.69 | Professional | 81 · Minimal assistant surgeon | $1.78 | $2.00 | $2.69 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.78 Median $2.00 Typical High $2.69 | Professional | 82 · Assistant surgeon, no resident | $1.78 | $2.00 | $2.69 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $1.58 Median $1.78 Typical High $2.34 | Professional | AS · PA/NP assist | $1.58 | $1.78 | $2.34 |
Where Wisconsin sits
The same service costs 3.2 times more in Massachusetts 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
$11.75
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.