How much rates vary
Facilitymedian $141 · 10th to 90th $107 to $490Professionalmedian $138 · 10th to 90th $107 to $468
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 $107.15 Median $107.15 Typical High $138.04 | Facility | None | $107.15 | $107.15 | $138.04 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $53.70 Median $53.70 Typical High $69.18 | Facility | 52 · Reduced service | $53.70 | $53.70 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $27.54 | Facility | 53 · Discontinued | $21.38 | $21.38 | $27.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $20.42 | Facility | 55 · Aftercare only | $16.22 | $16.22 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $13.80 | Facility | 56 · Pre-op care only | $10.72 | $10.72 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | None | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $53.70 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $21.38 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $16.22 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $363.08 | Professional | None | $120.23 | $125.89 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $489.78 Typical High $724.44 | Facility | None | $426.58 | $489.78 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $223.87 | Professional | None | $138.04 | $177.83 | $223.87 |
DeanCare Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $257.04 | Facility | None | $117.49 | $147.91 | $257.04 |
DeanCare Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $407.38 | Professional | None | $173.78 | $288.40 | $407.38 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $257.04 | Facility | None | $117.49 | $147.91 | $257.04 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $758.58 Typical High $912.01 | Professional | None | $194.98 | $758.58 | $912.01 |
Network Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $177.83 | Professional | None | $120.23 | $120.23 | $177.83 |
Prevea360 Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $257.04 | Facility | None | $117.49 | $147.91 | $257.04 |
Quartz Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $257.04 | Professional | None | $158.49 | $158.49 | $257.04 |
Security Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Security Health Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $331.13 | Professional | None | $169.82 | $257.04 | $331.13 |
United Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $346.74 | Professional | None | $144.54 | $213.80 | $346.74 |
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 $28.18 Median $45.71 Typical High $64.57 | Professional | 80 · Assistant surgeon | $28.18 | $45.71 | $64.57 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.18 Median $45.71 Typical High $64.57 | Professional | 81 · Minimal assistant surgeon | $28.18 | $45.71 | $64.57 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.18 Median $45.71 Typical High $64.57 | Professional | 82 · Assistant surgeon, no resident | $28.18 | $45.71 | $64.57 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $24.55 Median $39.81 Typical High $56.23 | Professional | AS · PA/NP assist | $24.55 | $39.81 | $56.23 |
Where Wisconsin sits
The same service costs 2.6 times more in North Dakota than in Delaware. 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
$138
ND $263DE $102
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.