How much rates vary
Facilitymedian $68 · 10th to 90th $46 to $245Professionalmedian $68 · 10th to 90th $46 to $234
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 $45.71 Median $45.71 Typical High $67.61 | Facility | None | $45.71 | $45.71 | $67.61 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $22.91 Median $22.91 Typical High $33.88 | Facility | 52 · Reduced service | $22.91 | $22.91 | $33.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $13.80 | Facility | 53 · Discontinued | $9.12 | $9.12 | $13.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $10.23 | Facility | 55 · Aftercare only | $6.92 | $6.92 | $10.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $6.76 | Facility | 56 · Pre-op care only | $4.57 | $4.57 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $67.61 | Professional | None | $45.71 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $22.91 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $13.49 Typical High $13.80 | Professional | 53 · Discontinued | $9.12 | $13.49 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $6.92 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.57 | $6.76 | $6.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $154.88 | Professional | None | $50.12 | $50.12 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $245.47 Typical High $363.08 | Facility | None | $213.80 | $245.47 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $112.20 | Professional | None | $58.88 | $89.13 | $112.20 |
DeanCare Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $109.65 | Facility | None | $50.12 | $64.57 | $109.65 |
DeanCare Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $199.53 | Professional | None | $83.18 | $134.90 | $199.53 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $109.65 | Facility | None | $50.12 | $64.57 | $109.65 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $316.23 Typical High $446.68 | Professional | None | $77.62 | $316.23 | $446.68 |
Network Health Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Prevea360 Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $109.65 | Facility | None | $50.12 | $64.57 | $109.65 |
Quartz Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $125.89 | Professional | None | $77.62 | $77.62 | $125.89 |
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 $112.20 Typical High $165.96 | Professional | None | $72.44 | $112.20 | $165.96 |
United Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $138.04 | Professional | None | $57.54 | $91.20 | $138.04 |
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 $13.49 Median $21.38 Typical High $32.36 | Professional | 80 · Assistant surgeon | $13.49 | $21.38 | $32.36 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.49 Median $21.38 Typical High $32.36 | Professional | 81 · Minimal assistant surgeon | $13.49 | $21.38 | $32.36 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.49 Median $21.38 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $13.49 | $21.38 | $32.36 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $11.75 Median $19.05 Typical High $28.18 | Professional | AS · PA/NP assist | $11.75 | $19.05 | $28.18 |
Where Wisconsin sits
The same service costs 3.0 times more in North Dakota 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· 13th of 51
$67.61
ND $129NY $42.66
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.