How much rates vary
Facilitymedian $87 · 10th to 90th $71 to $234Professionalmedian $112 · 10th to 90th $69 to $295
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 $70.79 Median $70.79 Typical High $81.28 | Facility | None | $70.79 | $70.79 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $309.03 | Professional | None | $70.79 | $81.28 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $125.89 Typical High $275.42 | Professional | None | $66.07 | $125.89 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $234.42 Typical High $354.81 | Facility | None | $208.93 | $234.42 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $199.53 | Professional | None | $83.18 | $102.33 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $72.44 Median $87.10 Typical High $162.18 | Facility | None | $72.44 | $87.10 | $162.18 |
DeanCare Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $169.82 | Professional | None | $123.03 | $141.25 | $169.82 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $87.10 Typical High $162.18 | Facility | None | $72.44 | $87.10 | $162.18 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $257.04 Typical High $512.86 | Professional | None | $91.20 | $257.04 | $512.86 |
Network Health Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $204.17 | Professional | None | $97.72 | $158.49 | $204.17 |
Prevea360 Setting Facility Modifier None Typical Low $72.44 Median $87.10 Typical High $162.18 | Facility | None | $72.44 | $87.10 | $162.18 |
Quartz Setting Professional Modifier None Typical Low $64.57 Median $138.04 Typical High $275.42 | Professional | None | $64.57 | $138.04 | $275.42 |
Quartz Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $114.82 | Professional | None | $77.62 | $95.50 | $114.82 |
Security Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | None | $85.11 | $85.11 | $100.00 |
Security Health Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $457.09 | Professional | None | $173.78 | $251.19 | $457.09 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
United Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $302.00 | Professional | None | $75.86 | $120.23 | $302.00 |
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 $35.48 Median $35.48 Typical High $40.74 | Facility | 52 · Reduced service | $35.48 | $35.48 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $16.22 | Facility | 53 · Discontinued | $14.13 | $14.13 | $16.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $12.30 | Facility | 55 · Aftercare only | $10.72 | $10.72 | $12.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $8.13 | Facility | 56 · Pre-op care only | $7.08 | $7.08 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $40.74 Typical High $154.88 | Professional | 52 · Reduced service | $35.48 | $40.74 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.22 Typical High $61.66 | Professional | 53 · Discontinued | $14.13 | $16.22 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.30 Typical High $46.77 | Professional | 55 · Aftercare only | $10.72 | $12.30 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.13 Typical High $30.90 | Professional | 56 · Pre-op care only | $7.08 | $8.13 | $30.90 |
Where Wisconsin sits
The same service costs 8.1 times more in Alaska than in Indiana. 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· 9th of 51
$112
AK $178IN $21.88
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.