How much rates vary
Facilitymedian $126 · 10th to 90th $59 to $380Professionalmedian $112 · 10th to 90th $49 to $251
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 $58.88 Median $67.61 Typical High $117.49 | Facility | None | $58.88 | $67.61 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $117.49 | Professional | None | $58.88 | $97.72 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $269.15 | Professional | None | $58.88 | $117.49 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $380.19 Typical High $562.34 | Facility | None | $331.13 | $380.19 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $234.42 | Professional | None | $45.71 | $91.20 | $234.42 |
DeanCare Setting Facility Modifier None Typical Low $69.18 Median $125.89 Typical High $229.09 | Facility | None | $69.18 | $125.89 | $229.09 |
DeanCare Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $331.13 | Professional | None | $109.65 | $169.82 | $331.13 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $125.89 Typical High $331.13 | Facility | None | $69.18 | $125.89 | $331.13 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $776.25 | Professional | None | $97.72 | $134.90 | $776.25 |
Network Health Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $128.82 | Facility | None | $93.33 | $93.33 | $128.82 |
Network Health Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $251.19 | Professional | None | $114.82 | $151.36 | $251.19 |
Prevea360 Setting Facility Modifier None Typical Low $69.18 Median $125.89 Typical High $229.09 | Facility | None | $69.18 | $125.89 | $229.09 |
Quartz Setting Professional Modifier None Typical Low $53.70 Median $125.89 Typical High $251.19 | Professional | None | $53.70 | $125.89 | $251.19 |
Quartz Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $245.47 | Professional | None | $45.71 | $91.20 | $245.47 |
Security Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $151.36 | Professional | None | $74.13 | $74.13 | $151.36 |
Security Health Setting Professional Modifier None Typical Low $100.00 Median $199.53 Typical High $257.04 | Professional | None | $100.00 | $199.53 | $257.04 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
United Setting Professional Modifier None Typical Low $30.90 Median $89.13 Typical High $154.88 | Professional | None | $30.90 | $89.13 | $154.88 |
9 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 Facility Modifier 52 · Reduced service Typical Low $29.51 Median $29.51 Typical High $58.88 | Facility | 52 · Reduced service | $29.51 | $29.51 | $58.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $23.44 | Facility | 53 · Discontinued | $11.75 | $11.75 | $23.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $17.78 | Facility | 55 · Aftercare only | $8.91 | $8.91 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $11.75 | Facility | 56 · Pre-op care only | $5.89 | $5.89 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $48.98 Typical High $58.88 | Professional | 52 · Reduced service | $29.51 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $19.50 Typical High $23.44 | Professional | 53 · Discontinued | $11.75 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $8.91 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $9.77 Typical High $11.75 | Professional | 56 · Pre-op care only | $5.89 | $9.77 | $11.75 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Wisconsin sits
The same service costs 2.8 times more in Alaska than in Maryland. 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· 6th of 51
$115
AK $178MD $64.57
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.