How much rates vary
Facilitymedian $148 · 10th to 90th $34 to $257Professionalmedian $120 · 10th to 90th $38 to $372
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 $51.29 Median $58.88 Typical High $147.91 | Facility | None | $51.29 | $58.88 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $89.13 Typical High $426.58 | Professional | None | $37.15 | $89.13 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $147.91 Typical High $389.05 | Professional | None | $51.29 | $147.91 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $257.04 Typical High $346.74 | Facility | None | $199.53 | $257.04 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $87.10 Typical High $199.53 | Professional | None | $30.90 | $87.10 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $32.36 Median $58.88 Typical High $154.88 | Facility | None | $32.36 | $58.88 | $154.88 |
DeanCare Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $186.21 | Professional | None | $51.29 | $97.72 | $186.21 |
Medica Setting Facility Modifier None Typical Low $32.36 Median $91.20 Typical High $181.97 | Facility | None | $32.36 | $91.20 | $181.97 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $309.03 Typical High $588.84 | Professional | None | $107.15 | $309.03 | $588.84 |
Network Health Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $60.26 | Facility | None | $42.66 | $42.66 | $60.26 |
Network Health Setting Professional Modifier None Typical Low $61.66 Median $123.03 Typical High $190.55 | Professional | None | $61.66 | $123.03 | $190.55 |
Prevea360 Setting Facility Modifier None Typical Low $32.36 Median $58.88 Typical High $154.88 | Facility | None | $32.36 | $58.88 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $42.66 Median $112.20 Typical High $281.84 | Professional | None | $42.66 | $112.20 | $281.84 |
Quartz Setting Professional Modifier None Typical Low $30.90 Median $87.10 Typical High $100.00 | Professional | None | $30.90 | $87.10 | $100.00 |
Security Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $102.33 | Professional | None | $34.67 | $34.67 | $102.33 |
Security Health Setting Professional Modifier None Typical Low $44.67 Median $117.49 Typical High $295.12 | Professional | None | $44.67 | $117.49 | $295.12 |
The Alliance Setting Professional Modifier None Typical Low $47.86 Median $117.49 Typical High $134.90 | Professional | None | $47.86 | $117.49 | $134.90 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $34.67 Median $91.20 Typical High $239.88 | Professional | None | $34.67 | $91.20 | $239.88 |
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 $25.70 Median $25.70 Typical High $72.44 | Facility | 52 · Reduced service | $25.70 | $25.70 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $29.51 | Facility | 53 · Discontinued | $10.23 | $10.23 | $29.51 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $21.88 | Facility | 55 · Aftercare only | $7.76 | $7.76 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $14.79 | Facility | 56 · Pre-op care only | $5.13 | $5.13 | $14.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $46.77 Typical High $223.87 | Professional | 52 · Reduced service | $25.70 | $46.77 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $18.62 Typical High $91.20 | Professional | 53 · Discontinued | $10.23 | $18.62 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $14.13 Typical High $67.61 | Professional | 55 · Aftercare only | $7.76 | $14.13 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $9.33 Typical High $45.71 | Professional | 56 · Pre-op care only | $5.13 | $9.33 | $45.71 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $25.70 Median $48.98 Typical High $93.33 | Professional | 51 · Multiple procedures | $25.70 | $48.98 | $93.33 |
Where Wisconsin sits
The same service costs 3.6 times more in North Carolina 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· 2nd of 51
$120
NC $123DC $33.88
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.