How much rates vary
Facilitymedian $59 · 10th to 90th $25 to $158Professionalmedian $54 · 10th to 90th $20 to $166
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 $24.55 Median $24.55 Typical High $31.62 | Facility | None | $24.55 | $24.55 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $158.49 | Professional | None | $24.55 | $24.55 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $56.23 | Facility | None | $43.65 | $52.48 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $45.71 Typical High $165.96 | Professional | None | $11.48 | $45.71 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $22.39 | Professional | None | $20.42 | $20.42 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $60.26 Typical High $79.43 | Facility | None | $51.29 | $60.26 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $60.26 Typical High $338.84 | Professional | None | $9.77 | $60.26 | $338.84 |
DeanCare Setting Facility Modifier None Typical Low $24.55 Median $128.82 Typical High $173.78 | Facility | None | $24.55 | $128.82 | $173.78 |
DeanCare Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | None | $120.23 | $120.23 | $134.90 |
Medica Setting Facility Modifier None Typical Low $24.55 Median $114.82 Typical High $204.17 | Facility | None | $24.55 | $114.82 | $204.17 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $93.33 Typical High $165.96 | Professional | None | $20.42 | $93.33 | $165.96 |
Network Health Setting Facility Modifier None Typical Low $24.55 Median $31.62 Typical High $57.54 | Facility | None | $24.55 | $31.62 | $57.54 |
Network Health Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $64.57 | Professional | None | $30.20 | $38.90 | $64.57 |
Prevea360 Setting Facility Modifier None Typical Low $15.49 Median $24.55 Typical High $44.67 | Facility | None | $15.49 | $24.55 | $44.67 |
Quartz Setting Professional Modifier None Typical Low $22.39 Median $46.77 Typical High $66.07 | Professional | None | $22.39 | $46.77 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $9.77 Median $53.70 Typical High $338.84 | Professional | None | $9.77 | $53.70 | $338.84 |
Security Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $42.66 | Professional | None | $34.67 | $34.67 | $42.66 |
Security Health Setting Professional Modifier None Typical Low $34.67 Median $109.65 Typical High $154.88 | Professional | None | $34.67 | $109.65 | $154.88 |
The Alliance Setting Professional Modifier None Typical Low $36.31 Median $87.10 Typical High $144.54 | Professional | None | $36.31 | $87.10 | $144.54 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $16.22 Median $28.18 Typical High $93.33 | Professional | None | $16.22 | $28.18 | $93.33 |
2 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 $12.02 Median $12.02 Typical High $77.62 | Professional | 52 · Reduced service | $12.02 | $12.02 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $31.62 | Professional | 53 · Discontinued | $4.90 | $4.90 | $31.62 |
Where Wisconsin sits
The same service costs 4.6 times more in Vermont than in Illinois. 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· 4th of 51
$56.23
VT $70.79IL $15.49
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.