How much rates vary
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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $478.63 | Professional | None | $181.97 | $181.97 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $691.83 | Professional | None | $181.97 | $194.98 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $354.81 Typical High $602.56 | Facility | None | $263.03 | $354.81 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $199.53 | Professional | None | $154.88 | $177.83 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $138.04 Median $199.53 Typical High $562.34 | Facility | None | $138.04 | $199.53 | $562.34 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $288.40 Typical High $346.74 | Facility | None | $169.82 | $288.40 | $346.74 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $288.40 | Professional | None | $165.96 | $199.53 | $288.40 |
Network Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Prevea360 Setting Facility Modifier None Typical Low $138.04 Median $199.53 Typical High $562.34 | Facility | None | $138.04 | $199.53 | $562.34 |
Quartz Setting Professional Modifier None Typical Low $213.80 Median $616.60 Typical High $776.25 | Professional | None | $213.80 | $616.60 | $776.25 |
Quartz Setting Facility Modifier None Typical Low $263.03 Median $602.56 Typical High $602.56 | Facility | None | $263.03 | $602.56 | $602.56 |
Quartz Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Security Health Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $186.21 | Professional | None | $128.82 | $151.36 | $186.21 |
United Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $302.00 | Professional | None | $173.78 | $213.80 | $302.00 |
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 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $79.43 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $52.48 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $52.48 |
Where Wisconsin sits
The same service costs 562.3 times more in Montana than in Rhode Island. 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· 17th of 51
$200
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.