How much rates vary
Facilitymedian $24 · 10th to 90th $11 to $3,162Professionalmedian $47 · 10th to 90th $17 to $126
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 $11.75 Median $11.75 Typical High $23.99 | Facility | None | $11.75 | $11.75 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $23.99 Typical High $147.91 | Professional | None | $11.75 | $23.99 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $54.95 Typical High $134.90 | Professional | None | $16.98 | $54.95 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $53.70 Typical High $81.28 | Facility | None | $47.86 | $53.70 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $33.88 Typical High $64.57 | Professional | None | $16.60 | $33.88 | $64.57 |
DeanCare Setting Facility Modifier None Typical Low $11.22 Median $2,630.27 Typical High $5,128.61 | Facility | None | $11.22 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $21.38 Median $27.54 Typical High $50.12 | Professional | None | $21.38 | $27.54 | $50.12 |
Medica Setting Facility Modifier None Typical Low $9.77 Median $17.78 Typical High $37.15 | Facility | None | $9.77 | $17.78 | $37.15 |
Medica Setting Professional Modifier None Typical Low $19.50 Median $63.10 Typical High $208.93 | Professional | None | $19.50 | $63.10 | $208.93 |
Network Health Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $19.50 | Facility | None | $12.88 | $12.88 | $19.50 |
Network Health Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $54.95 | Professional | None | $25.70 | $38.90 | $54.95 |
Prevea360 Setting Facility Modifier None Typical Low $9.77 Median $17.38 Typical High $31.62 | Facility | None | $9.77 | $17.38 | $31.62 |
Quartz Setting Professional Modifier None Typical Low $17.38 Median $38.02 Typical High $74.13 | Professional | None | $17.38 | $38.02 | $74.13 |
Quartz Setting Professional Modifier None Typical Low $16.60 Median $30.20 Typical High $33.88 | Professional | None | $16.60 | $30.20 | $33.88 |
Security Health Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $91.20 | Professional | None | $46.77 | $46.77 | $91.20 |
Security Health Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $125.89 | Professional | None | $50.12 | $89.13 | $125.89 |
United Setting Professional Modifier None Typical Low $13.49 Median $38.02 Typical High $83.18 | Professional | None | $13.49 | $38.02 | $83.18 |
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 Facility Modifier 52 · Reduced service Typical Low $5.89 Median $5.89 Typical High $12.02 | Facility | 52 · Reduced service | $5.89 | $5.89 | $12.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $4.79 | Facility | 53 · Discontinued | $2.34 | $2.34 | $4.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.78 Median $1.78 Typical High $3.63 | Facility | 55 · Aftercare only | $1.78 | $1.78 | $3.63 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $2.40 | Facility | 56 · Pre-op care only | $1.17 | $1.17 | $2.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.89 Median $12.02 Typical High $74.13 | Professional | 52 · Reduced service | $5.89 | $12.02 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $4.79 Typical High $29.51 | Professional | 53 · Discontinued | $2.34 | $4.79 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $3.63 Typical High $22.39 | Professional | 55 · Aftercare only | $1.78 | $3.63 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $2.40 Typical High $14.79 | Professional | 56 · Pre-op care only | $1.17 | $2.40 | $14.79 |
Where Wisconsin sits
The same service costs 3.2 times more in Wisconsin than in Nebraska. 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· 1st of 51
$46.77
WI $46.77NE $14.45
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.