How much rates vary
Facilitymedian $78 · 10th to 90th $20 to $263Professionalmedian $60 · 10th to 90th $18 to $170
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 $20.42 Median $20.42 Typical High $77.62 | Facility | None | $20.42 | $20.42 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $61.66 Typical High $77.62 | Professional | None | $20.42 | $61.66 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $39.81 Typical High $204.17 | Professional | None | $20.42 | $39.81 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $251.19 Typical High $380.19 | Facility | None | $223.87 | $251.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $57.54 Typical High $158.49 | Professional | None | $15.85 | $57.54 | $158.49 |
DeanCare Setting Facility Modifier None Typical Low $23.44 Median $43.65 Typical High $144.54 | Facility | None | $23.44 | $43.65 | $144.54 |
DeanCare Setting Professional Modifier None Typical Low $37.15 Median $61.66 Typical High $218.78 | Professional | None | $37.15 | $61.66 | $218.78 |
Medica Setting Facility Modifier None Typical Low $23.44 Median $75.86 Typical High $331.13 | Facility | None | $23.44 | $75.86 | $331.13 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $524.81 | Professional | None | $58.88 | $89.13 | $524.81 |
Network Health Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $50.12 | Facility | None | $31.62 | $31.62 | $50.12 |
Network Health Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $165.96 | Professional | None | $46.77 | $75.86 | $165.96 |
Prevea360 Setting Facility Modifier None Typical Low $23.44 Median $43.65 Typical High $144.54 | Facility | None | $23.44 | $43.65 | $144.54 |
Quartz Setting Professional Modifier None Typical Low $19.05 Median $85.11 Typical High $173.78 | Professional | None | $19.05 | $85.11 | $173.78 |
Quartz Setting Professional Modifier None Typical Low $15.85 Median $56.23 Typical High $162.18 | Professional | None | $15.85 | $56.23 | $162.18 |
Security Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $100.00 | Professional | None | $25.70 | $25.70 | $100.00 |
Security Health Setting Professional Modifier None Typical Low $34.67 Median $95.50 Typical High $169.82 | Professional | None | $34.67 | $95.50 | $169.82 |
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 $20.42 Median $37.15 Typical High $100.00 | Professional | None | $20.42 | $37.15 | $100.00 |
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 $10.00 Median $10.00 Typical High $38.90 | Facility | 52 · Reduced service | $10.00 | $10.00 | $38.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $15.49 | Facility | 53 · Discontinued | $4.07 | $4.07 | $15.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $11.75 | Facility | 55 · Aftercare only | $3.02 | $3.02 | $11.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $7.76 | Facility | 56 · Pre-op care only | $2.04 | $2.04 | $7.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.00 Median $30.90 Typical High $38.90 | Professional | 52 · Reduced service | $10.00 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $12.30 Typical High $15.49 | Professional | 53 · Discontinued | $4.07 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $9.33 Typical High $11.75 | Professional | 55 · Aftercare only | $3.02 | $9.33 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $6.17 Typical High $7.76 | Professional | 56 · Pre-op care only | $2.04 | $6.17 | $7.76 |
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 4.4 times more in Hawaii than in Washington, DC. 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· 13th of 51
$60.26
HI $110DC $25.12
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.