How much rates vary
Facilitymedian $417 · 10th to 90th $263 to $813Professionalmedian $288 · 10th to 90th $245 to $525
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 $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $707.95 | Professional | None | $269.15 | $269.15 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $537.03 Typical High $602.56 | Facility | None | $501.19 | $537.03 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $371.54 | Professional | None | $245.47 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $660.69 Typical High $812.83 | Facility | None | $398.11 | $660.69 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $501.19 | Professional | None | $269.15 | $346.74 | $501.19 |
DeanCare Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $575.44 | Facility | None | $263.03 | $263.03 | $575.44 |
DeanCare Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $575.44 | Facility | None | $263.03 | $263.03 | $575.44 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $398.11 | Professional | None | $229.09 | $275.42 | $398.11 |
Network Health Setting Facility Modifier None Typical Low $263.03 Median $269.15 Typical High $269.15 | Facility | None | $263.03 | $269.15 | $269.15 |
Prevea360 Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $575.44 | Facility | None | $263.03 | $263.03 | $575.44 |
Prevea360 Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $724.44 | Professional | None | $269.15 | $426.58 | $724.44 |
Quartz Setting Facility Modifier None Typical Low $354.81 Median $812.83 Typical High $812.83 | Facility | None | $354.81 | $812.83 | $812.83 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Security Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $446.68 | Professional | None | $363.08 | $363.08 | $446.68 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $416.87 | Professional | None | $239.88 | $288.40 | $416.87 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $134.90 Typical High $354.81 | Professional | 52 · Reduced service | $134.90 | $134.90 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $141.25 | Professional | 53 · Discontinued | $53.70 | $53.70 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $107.15 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $70.79 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $70.79 |
Where Wisconsin sits
The same service costs 2.3 times more in Arizona than in Alabama. 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· 14th of 51
$288
AZ $372AL $162
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.