How much rates vary
Facilitymedian $62 · 10th to 90th $25 to $186Professionalmedian $72 · 10th to 90th $26 to $240
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 $24.55 Median $24.55 Typical High $61.66 | Facility | None | $24.55 | $24.55 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $61.66 Typical High $371.54 | Professional | None | $24.55 | $61.66 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $72.44 Typical High $95.50 | Professional | None | $28.84 | $72.44 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $186.21 Typical High $275.42 | Facility | None | $162.18 | $186.21 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $66.07 Typical High $158.49 | Professional | None | $26.30 | $66.07 | $158.49 |
DeanCare Setting Facility Modifier None Typical Low $26.30 Median $51.29 Typical High $125.89 | Facility | None | $26.30 | $51.29 | $125.89 |
DeanCare Setting Professional Modifier None Typical Low $41.69 Median $75.86 Typical High $165.96 | Professional | None | $41.69 | $75.86 | $165.96 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $51.29 Typical High $125.89 | Facility | None | $26.30 | $51.29 | $125.89 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $177.83 Typical High $478.63 | Professional | None | $85.11 | $177.83 | $478.63 |
Network Health Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Network Health Setting Professional Modifier None Typical Low $34.67 Median $91.20 Typical High $194.98 | Professional | None | $34.67 | $91.20 | $194.98 |
Prevea360 Setting Facility Modifier None Typical Low $26.30 Median $51.29 Typical High $125.89 | Facility | None | $26.30 | $51.29 | $125.89 |
Quartz Setting Professional Modifier None Typical Low $32.36 Median $83.18 Typical High $223.87 | Professional | None | $32.36 | $83.18 | $223.87 |
Quartz Setting Professional Modifier None Typical Low $26.30 Median $64.57 Typical High $112.20 | Professional | None | $26.30 | $64.57 | $112.20 |
Security Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $107.15 | Professional | None | $38.90 | $38.90 | $107.15 |
Security Health Setting Professional Modifier None Typical Low $38.90 Median $100.00 Typical High $281.84 | Professional | None | $38.90 | $100.00 | $281.84 |
The Alliance Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $67.61 | Professional | None | $44.67 | $57.54 | $67.61 |
United Setting Professional Modifier None Typical Low $29.51 Median $85.11 Typical High $245.47 | Professional | None | $29.51 | $85.11 | $245.47 |
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 $12.30 Median $12.30 Typical High $30.90 | Facility | 52 · Reduced service | $12.30 | $12.30 | $30.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $12.30 | Facility | 53 · Discontinued | $4.90 | $4.90 | $12.30 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $9.33 | Facility | 55 · Aftercare only | $3.72 | $3.72 | $9.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $6.17 | Facility | 56 · Pre-op care only | $2.45 | $2.45 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $30.90 Typical High $186.21 | Professional | 52 · Reduced service | $12.30 | $30.90 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $12.30 Typical High $74.13 | Professional | 53 · Discontinued | $4.90 | $12.30 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $9.33 Typical High $56.23 | Professional | 55 · Aftercare only | $3.72 | $9.33 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $6.17 Typical High $37.15 | Professional | 56 · Pre-op care only | $2.45 | $6.17 | $37.15 |
Where Wisconsin sits
The same service costs 4.4 times more in North Dakota than in Kentucky. 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· 12th of 51
$72.44
ND $112KY $25.70
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.