How much rates vary
Facilitymedian $38 · 10th to 90th $22 to $123Professionalmedian $38 · 10th to 90th $21 to $89
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 $21.88 Median $21.88 Typical High $38.02 | Facility | None | $21.88 | $21.88 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $38.02 | Professional | None | $21.88 | $33.11 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $38.02 Typical High $91.20 | Professional | None | $22.39 | $38.02 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $123.03 Typical High $181.97 | Facility | None | $107.15 | $123.03 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $29.51 Typical High $75.86 | Professional | None | $16.98 | $29.51 | $75.86 |
DeanCare Setting Facility Modifier None Typical Low $25.12 Median $44.67 Typical High $77.62 | Facility | None | $25.12 | $44.67 | $77.62 |
DeanCare Setting Professional Modifier None Typical Low $40.74 Median $63.10 Typical High $107.15 | Professional | None | $40.74 | $63.10 | $107.15 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $44.67 Typical High $77.62 | Facility | None | $25.12 | $44.67 | $77.62 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $245.47 | Professional | None | $37.15 | $45.71 | $245.47 |
Network Health Setting Professional Modifier None Typical Low $47.86 Median $81.28 Typical High $89.13 | Professional | None | $47.86 | $81.28 | $89.13 |
Prevea360 Setting Facility Modifier None Typical Low $25.12 Median $44.67 Typical High $77.62 | Facility | None | $25.12 | $44.67 | $77.62 |
Quartz Setting Professional Modifier None Typical Low $20.89 Median $44.67 Typical High $89.13 | Professional | None | $20.89 | $44.67 | $89.13 |
Quartz Setting Professional Modifier None Typical Low $16.98 Median $29.51 Typical High $79.43 | Professional | None | $16.98 | $29.51 | $79.43 |
Security Health Setting Professional Modifier None Typical Low $33.88 Median $53.70 Typical High $97.72 | Professional | None | $33.88 | $53.70 | $97.72 |
The Alliance Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $128.82 | Professional | None | $42.66 | $42.66 | $128.82 |
United Setting Professional Modifier None Typical Low $21.38 Median $38.90 Typical High $58.88 | Professional | None | $21.38 | $38.90 | $58.88 |
8 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 $10.96 Median $10.96 Typical High $19.05 | Facility | 52 · Reduced service | $10.96 | $10.96 | $19.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $7.59 | Facility | 53 · Discontinued | $4.37 | $4.37 | $7.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $5.75 | Facility | 55 · Aftercare only | $3.24 | $3.24 | $5.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $3.80 | Facility | 56 · Pre-op care only | $2.19 | $2.19 | $3.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $16.22 Typical High $19.05 | Professional | 52 · Reduced service | $10.96 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $6.61 Typical High $7.59 | Professional | 53 · Discontinued | $4.37 | $6.61 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.90 Typical High $5.75 | Professional | 55 · Aftercare only | $3.24 | $4.90 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $3.31 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.19 | $3.31 | $3.80 |
Where Wisconsin sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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
$38.02
AK $67.61NJ $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.