How much rates vary
Facilitymedian $380 · 10th to 90th $288 to $1,230Professionalmedian $437 · 10th to 90th $288 to $1,259
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 $288.40 Median $331.13 Typical High $436.52 | Facility | None | $288.40 | $331.13 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $436.52 | Professional | None | $288.40 | $371.54 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $1,122.02 | Professional | None | $275.42 | $398.11 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,089.30 | Facility | None | $1,230.27 | $1,412.54 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $660.69 | Professional | None | $457.09 | $457.09 | $660.69 |
DeanCare Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $831.76 | Facility | None | $288.40 | $457.09 | $831.76 |
DeanCare Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,047.13 | Professional | None | $575.44 | $851.14 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $436.52 Typical High $831.76 | Facility | None | $288.40 | $436.52 | $831.76 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $2,398.83 Typical High $2,754.23 | Professional | None | $478.63 | $2,398.83 | $2,754.23 |
Network Health Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $1,047.13 | Professional | None | $346.74 | $524.81 | $1,047.13 |
Prevea360 Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $831.76 | Facility | None | $288.40 | $457.09 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $398.11 Median $812.83 Typical High $1,258.93 | Professional | None | $398.11 | $812.83 | $1,258.93 |
Quartz Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Security Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $562.34 | Professional | None | $457.09 | $457.09 | $562.34 |
Security Health Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $1,258.93 | Professional | None | $363.08 | $549.54 | $1,258.93 |
United Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
United Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $1,230.27 | Professional | None | $354.81 | $524.81 | $1,230.27 |
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 $190.55 Median $190.55 Typical High $218.78 | Facility | 52 · Reduced service | $190.55 | $190.55 | $218.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $87.10 | Facility | 53 · Discontinued | $75.86 | $75.86 | $87.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $66.07 | Facility | 55 · Aftercare only | $57.54 | $57.54 | $66.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $43.65 | Facility | 56 · Pre-op care only | $38.02 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $190.55 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $87.10 Typical High $102.33 | Professional | 53 · Discontinued | $75.86 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $57.54 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.02 | $43.65 | $51.29 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $134.90 Typical High $165.96 | Professional | 80 · Assistant surgeon | $91.20 | $134.90 | $165.96 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $134.90 Typical High $165.96 | Professional | 81 · Minimal assistant surgeon | $91.20 | $134.90 | $165.96 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $134.90 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $134.90 | $165.96 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $117.49 Typical High $144.54 | Professional | AS · PA/NP assist | $79.43 | $117.49 | $144.54 |
Where Wisconsin sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 18th of 51
$437
WY $661MD $309
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.