How much rates vary
Facilitymedian $107 · 10th to 90th $71 to $331Professionalmedian $138 · 10th to 90th $76 to $316
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 $107.15 | Facility | None | $70.79 | $70.79 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $154.88 | Professional | None | $70.79 | $100.00 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $281.84 | Professional | None | $87.10 | $154.88 | $281.84 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $151.36 | Professional | None | $100.00 | $128.82 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $331.13 Typical High $501.19 | Facility | None | $295.12 | $331.13 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $245.47 | Professional | None | $81.28 | $123.03 | $245.47 |
DeanCare Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $213.80 | Facility | None | $70.79 | $104.71 | $213.80 |
DeanCare Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $245.47 | Professional | None | $131.83 | $194.98 | $245.47 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $213.80 | Facility | None | $70.79 | $104.71 | $213.80 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $467.74 Typical High $691.83 | Professional | None | $125.89 | $467.74 | $691.83 |
Network Health Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $218.78 | Professional | None | $151.36 | $181.97 | $218.78 |
Prevea360 Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $213.80 | Facility | None | $70.79 | $104.71 | $213.80 |
Quartz Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $295.12 | Professional | None | $100.00 | $173.78 | $295.12 |
Quartz Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $141.25 | Professional | None | $81.28 | $112.20 | $141.25 |
Security Health Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | None | $112.20 | $112.20 | $162.18 |
Security Health Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $309.03 | Professional | None | $107.15 | $190.55 | $309.03 |
The Alliance Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $263.03 | Professional | None | $95.50 | $169.82 | $263.03 |
United Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $257.04 | Professional | None | $79.43 | $131.83 | $257.04 |
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 $35.48 Median $35.48 Typical High $52.48 | Facility | 52 · Reduced service | $35.48 | $35.48 | $52.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $15.85 | Facility | 55 · Aftercare only | $10.47 | $10.47 | $15.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $10.72 | Facility | 56 · Pre-op care only | $7.08 | $7.08 | $10.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $50.12 Typical High $54.95 | Professional | 52 · Reduced service | $35.48 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $15.14 Typical High $16.60 | Professional | 55 · Aftercare only | $10.47 | $15.14 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.00 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.08 | $10.00 | $10.96 |
Where Wisconsin sits
The same service costs 2.9 times more in Alaska 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· 9th of 51
$138
AK $204DC $70.79
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.