How much rates vary
Facilitymedian $126 · 10th to 90th $76 to $245Professionalmedian $83 · 10th to 90th $72 to $174
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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $213.80 | Professional | None | $75.86 | $75.86 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $151.36 Typical High $165.96 | Facility | None | $138.04 | $151.36 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $109.65 | Professional | None | $74.13 | $75.86 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $181.97 Typical High $245.47 | Facility | None | $112.20 | $181.97 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $194.98 | Professional | None | $79.43 | $95.50 | $194.98 |
DeanCare Setting Facility Modifier None Typical Low $25.12 Median $75.86 Typical High $75.86 | Facility | None | $25.12 | $75.86 | $75.86 |
DeanCare Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $75.86 Typical High $75.86 | Facility | None | $25.12 | $75.86 | $75.86 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $120.23 | Professional | None | $69.18 | $83.18 | $120.23 |
Network Health Setting Facility Modifier None Typical Low $77.62 Median $79.43 Typical High $79.43 | Facility | None | $77.62 | $79.43 | $79.43 |
Prevea360 Setting Facility Modifier None Typical Low $25.12 Median $75.86 Typical High $75.86 | Facility | None | $25.12 | $75.86 | $75.86 |
Prevea360 Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Quartz Setting Professional Modifier None Typical Low $67.61 Median $120.23 Typical High $208.93 | Professional | None | $67.61 | $120.23 | $208.93 |
Quartz Setting Facility Modifier None Typical Low $107.15 Median $245.47 Typical High $245.47 | Facility | None | $107.15 | $245.47 | $245.47 |
Quartz Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Security Health Setting Professional Modifier None Typical Low $27.54 Median $102.33 Typical High $125.89 | Professional | None | $27.54 | $102.33 | $125.89 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $125.89 | Professional | None | $72.44 | $87.10 | $125.89 |
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 $37.15 Median $37.15 Typical High $107.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $42.66 | Professional | 53 · Discontinued | $15.14 | $15.14 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $32.36 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $21.38 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $21.38 |
Where Wisconsin sits
The same service costs 3.0 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· 11th of 51
$83.18
AZ $117AL $39.81
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.