How much rates vary
Facilitymedian $32 · 10th to 90th $25 to $85Professionalmedian $54 · 10th to 90th $24 to $148
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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $60.26 | Professional | None | $24.55 | $24.55 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.44 Median $70.79 Typical High $169.82 | Professional | None | $23.44 | $70.79 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $83.18 Typical High $123.03 | Facility | None | $72.44 | $83.18 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $93.33 | Professional | None | $23.99 | $23.99 | $93.33 |
DeanCare Setting Facility Modifier None Typical Low $22.39 Median $29.51 Typical High $56.23 | Facility | None | $22.39 | $29.51 | $56.23 |
DeanCare Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $74.13 | Professional | None | $46.77 | $58.88 | $74.13 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $29.51 Typical High $56.23 | Facility | None | $22.39 | $29.51 | $56.23 |
Medica Setting Professional Modifier None Typical Low $23.99 Median $75.86 Typical High $147.91 | Professional | None | $23.99 | $75.86 | $147.91 |
Network Health Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Network Health Setting Professional Modifier None Typical Low $28.84 Median $50.12 Typical High $85.11 | Professional | None | $28.84 | $50.12 | $85.11 |
Prevea360 Setting Facility Modifier None Typical Low $22.39 Median $29.51 Typical High $56.23 | Facility | None | $22.39 | $29.51 | $56.23 |
Prevea360 Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Quartz Setting Professional Modifier None Typical Low $28.18 Median $57.54 Typical High $112.20 | Professional | None | $28.18 | $57.54 | $112.20 |
Quartz Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $38.90 | Professional | None | $23.99 | $23.99 | $38.90 |
Security Health Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $169.82 | Professional | None | $54.95 | $114.82 | $169.82 |
United Setting Professional Modifier None Typical Low $23.99 Median $52.48 Typical High $95.50 | Professional | None | $23.99 | $52.48 | $95.50 |
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 $12.30 Median $12.30 Typical High $30.20 | Professional | 52 · Reduced service | $12.30 | $12.30 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $12.02 | Professional | 53 · Discontinued | $4.90 | $4.90 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $8.91 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $6.03 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $6.03 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.76 Median $9.55 Typical High $12.02 | Professional | 80 · Assistant surgeon | $7.76 | $9.55 | $12.02 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.76 Median $9.55 Typical High $12.02 | Professional | 81 · Minimal assistant surgeon | $7.76 | $9.55 | $12.02 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.76 Median $9.55 Typical High $12.02 | Professional | 82 · Assistant surgeon, no resident | $7.76 | $9.55 | $12.02 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $6.92 Median $8.32 Typical High $10.47 | Professional | AS · PA/NP assist | $6.92 | $8.32 | $10.47 |
Where Wisconsin sits
The same service costs 4.1 times more in Wyoming than in Kentucky. 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· 3rd of 51
$53.70
WY $75.86KY $18.62
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.