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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $363.08 | Professional | None | $229.09 | $239.88 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $288.40 | Professional | None | $234.42 | $239.88 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $478.63 Typical High $794.33 | Facility | None | $346.74 | $478.63 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $263.03 | Professional | None | $223.87 | $251.19 | $263.03 |
DeanCare Setting Facility Modifier None Typical Low $218.78 Median $257.04 Typical High $257.04 | Facility | None | $218.78 | $257.04 | $257.04 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $302.00 Typical High $501.19 | Facility | None | $218.78 | $302.00 | $501.19 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $371.54 | Professional | None | $213.80 | $257.04 | $371.54 |
Prevea360 Setting Facility Modifier None Typical Low $218.78 Median $257.04 Typical High $257.04 | Facility | None | $218.78 | $257.04 | $257.04 |
Quartz Setting Facility Modifier None Typical Low $346.74 Median $794.33 Typical High $794.33 | Facility | None | $346.74 | $794.33 | $794.33 |
Quartz Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Security Health Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $257.04 | Professional | None | $131.83 | $208.93 | $257.04 |
United Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $371.54 | Professional | None | $213.80 | $269.15 | $371.54 |
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 $112.20 Median $120.23 Typical High $173.78 | Professional | 52 · Reduced service | $112.20 | $120.23 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $70.79 | Professional | 53 · Discontinued | $45.71 | $47.86 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $52.48 | Professional | 55 · Aftercare only | $33.88 | $36.31 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $34.67 | Professional | 56 · Pre-op care only | $22.91 | $23.99 | $34.67 |
Where Wisconsin sits
The same service costs 2.1 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· 27th of 51
$245
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.