How much rates vary
Facilitymedian $60 · 10th to 90th $46 to $162Professionalmedian $71 · 10th to 90th $46 to $316
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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $316.23 | Professional | None | $45.71 | $45.71 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $234.42 | Facility | None | $141.25 | $158.49 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $89.13 | Professional | None | $50.12 | $50.12 | $89.13 |
DeanCare Setting Facility Modifier None Typical Low $46.77 Median $58.88 Typical High $107.15 | Facility | None | $46.77 | $58.88 | $107.15 |
DeanCare Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $134.90 | Professional | None | $75.86 | $107.15 | $134.90 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $58.88 Typical High $107.15 | Facility | None | $46.77 | $58.88 | $107.15 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $112.20 Typical High $346.74 | Professional | None | $63.10 | $112.20 | $346.74 |
Network Health Setting Professional Modifier None Typical Low $39.81 Median $66.07 Typical High $141.25 | Professional | None | $39.81 | $66.07 | $141.25 |
Prevea360 Setting Facility Modifier None Typical Low $46.77 Median $58.88 Typical High $107.15 | Facility | None | $46.77 | $58.88 | $107.15 |
Quartz Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $151.36 | Professional | None | $60.26 | $112.20 | $151.36 |
Quartz Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Security Health Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Security Health Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $112.20 | Professional | None | $72.44 | $100.00 | $112.20 |
United Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $151.36 | Professional | None | $56.23 | $81.28 | $151.36 |
8 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 Professional Modifier 52 · Reduced service Typical Low $22.91 Median $22.91 Typical High $158.49 | Professional | 52 · Reduced service | $22.91 | $22.91 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $63.10 | Professional | 53 · Discontinued | $9.12 | $9.12 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $46.77 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $31.62 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $31.62 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.02 Median $16.98 Typical High $21.88 | Professional | 80 · Assistant surgeon | $12.02 | $16.98 | $21.88 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.02 Median $16.98 Typical High $21.88 | Professional | 81 · Minimal assistant surgeon | $12.02 | $16.98 | $21.88 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.02 Median $16.98 Typical High $21.88 | Professional | 82 · Assistant surgeon, no resident | $12.02 | $16.98 | $21.88 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $10.72 Median $14.79 Typical High $19.05 | Professional | AS · PA/NP assist | $10.72 | $14.79 | $19.05 |
Where Wisconsin sits
The same service costs 3.1 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· 11th of 51
$70.79
AK $145NY $46.77
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.