How much rates vary
Facilitymedian $95 · 10th to 90th $30 to $324Professionalmedian $78 · 10th to 90th $29 to $209
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 $30.20 Median $30.20 Typical High $95.50 | Facility | None | $30.20 | $30.20 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $77.62 Typical High $95.50 | Professional | None | $30.20 | $77.62 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $97.72 Typical High $213.80 | Professional | None | $30.90 | $97.72 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $309.03 Typical High $467.74 | Facility | None | $275.42 | $309.03 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $72.44 Typical High $190.55 | Professional | None | $23.44 | $72.44 | $190.55 |
DeanCare Setting Facility Modifier None Typical Low $35.48 Median $64.57 Typical High $181.97 | Facility | None | $35.48 | $64.57 | $181.97 |
DeanCare Setting Professional Modifier None Typical Low $56.23 Median $89.13 Typical High $269.15 | Professional | None | $56.23 | $89.13 | $269.15 |
Medica Setting Facility Modifier None Typical Low $35.48 Median $93.33 Typical High $331.13 | Facility | None | $35.48 | $93.33 | $331.13 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $645.65 | Professional | None | $75.86 | $117.49 | $645.65 |
Network Health Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $81.28 | Facility | None | $47.86 | $47.86 | $81.28 |
Network Health Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $223.87 | Professional | None | $70.79 | $93.33 | $223.87 |
Prevea360 Setting Facility Modifier None Typical Low $35.48 Median $64.57 Typical High $181.97 | Facility | None | $35.48 | $64.57 | $181.97 |
Quartz Setting Professional Modifier None Typical Low $28.84 Median $104.71 Typical High $218.78 | Professional | None | $28.84 | $104.71 | $218.78 |
Quartz Setting Professional Modifier None Typical Low $23.44 Median $74.13 Typical High $199.53 | Professional | None | $23.44 | $74.13 | $199.53 |
Security Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $123.03 | Professional | None | $38.90 | $38.90 | $123.03 |
Security Health Setting Professional Modifier None Typical Low $51.29 Median $120.23 Typical High $208.93 | Professional | None | $51.29 | $120.23 | $208.93 |
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 $30.20 Median $56.23 Typical High $125.89 | Professional | None | $30.20 | $56.23 | $125.89 |
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 $15.14 Median $15.14 Typical High $47.86 | Facility | 52 · Reduced service | $15.14 | $15.14 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $19.50 | Facility | 53 · Discontinued | $6.03 | $6.03 | $19.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $14.45 | Facility | 55 · Aftercare only | $4.57 | $4.57 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $9.55 | Facility | 56 · Pre-op care only | $3.02 | $3.02 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $38.02 Typical High $47.86 | Professional | 52 · Reduced service | $15.14 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $6.03 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $11.48 Typical High $14.45 | Professional | 55 · Aftercare only | $4.57 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $7.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $3.02 | $7.76 | $9.55 |
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 3.5 times more in Hawaii 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· 14th of 51
$77.62
HI $135MD $38.02
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.