How much rates vary
Facilitymedian $186 · 10th to 90th $141 to $251Professionalmedian $234 · 10th to 90th $158 to $589
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 $141.25 Median $162.18 Typical High $218.78 | Facility | None | $141.25 | $162.18 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $218.78 | Professional | None | $141.25 | $186.21 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $537.03 | Professional | None | $173.78 | $281.84 | $537.03 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $295.12 | Professional | None | $194.98 | $251.19 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $478.63 | Professional | None | $199.53 | $234.42 | $478.63 |
DeanCare Setting Facility Modifier None Typical Low $186.21 Median $218.78 Typical High $426.58 | Facility | None | $186.21 | $218.78 | $426.58 |
DeanCare Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $524.81 | Professional | None | $323.59 | $380.19 | $524.81 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $234.42 Typical High $426.58 | Facility | None | $186.21 | $234.42 | $426.58 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $812.83 Typical High $1,348.96 | Professional | None | $229.09 | $812.83 | $1,348.96 |
Network Health Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $549.54 | Professional | None | $346.74 | $407.38 | $549.54 |
Prevea360 Setting Facility Modifier None Typical Low $186.21 Median $218.78 Typical High $426.58 | Facility | None | $186.21 | $218.78 | $426.58 |
Quartz Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $602.56 | Professional | None | $234.42 | $426.58 | $602.56 |
Quartz Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $288.40 | Professional | None | $199.53 | $234.42 | $288.40 |
Security Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | None | $346.74 | $346.74 | $407.38 |
Security Health Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $660.69 | Professional | None | $346.74 | $512.86 | $660.69 |
The Alliance Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $537.03 | Professional | None | $257.04 | $436.52 | $537.03 |
United Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $537.03 | Professional | None | $204.17 | $288.40 | $537.03 |
6 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 $93.33 Median $104.71 Typical High $109.65 | Facility | 52 · Reduced service | $93.33 | $104.71 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $30.90 Typical High $33.11 | Facility | 55 · Aftercare only | $28.18 | $30.90 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.89 Typical High $21.88 | Facility | 56 · Pre-op care only | $18.62 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $104.71 Typical High $109.65 | Professional | 52 · Reduced service | $93.33 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $33.11 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.62 | $21.38 | $21.88 |
Where Wisconsin sits
The same service costs 2.4 times more in Alaska than in Alabama. 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· 15th of 51
$234
AK $380AL $158
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.