How much rates vary
Facilitymedian $115 · 10th to 90th $79 to $363Professionalmedian $148 · 10th to 90th $87 to $347
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 $79.43 Median $79.43 Typical High $114.82 | Facility | None | $79.43 | $79.43 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $147.91 | Professional | None | $79.43 | $107.15 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $309.03 | Professional | None | $100.00 | $169.82 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $165.96 | Professional | None | $107.15 | $141.25 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $363.08 Typical High $537.03 | Facility | None | $316.23 | $363.08 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $263.03 | Professional | None | $91.20 | $131.83 | $263.03 |
DeanCare Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $234.42 | Facility | None | $81.28 | $114.82 | $234.42 |
DeanCare Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $269.15 | Professional | None | $147.91 | $213.80 | $269.15 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $234.42 | Facility | None | $81.28 | $114.82 | $234.42 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $426.58 Typical High $741.31 | Professional | None | $125.89 | $426.58 | $741.31 |
Network Health Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $234.42 | Professional | None | $165.96 | $199.53 | $234.42 |
Prevea360 Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $234.42 | Facility | None | $81.28 | $114.82 | $234.42 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $323.59 | Professional | None | $112.20 | $194.98 | $323.59 |
Quartz Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $154.88 | Professional | None | $91.20 | $123.03 | $154.88 |
Security Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $199.53 | Professional | None | $141.25 | $141.25 | $199.53 |
Security Health Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $331.13 | Professional | None | $144.54 | $234.42 | $331.13 |
The Alliance Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $295.12 | Professional | None | $144.54 | $223.87 | $295.12 |
United Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $281.84 | Professional | None | $93.33 | $144.54 | $281.84 |
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 $39.81 Median $39.81 Typical High $57.54 | Facility | 52 · Reduced service | $39.81 | $39.81 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $17.38 | Facility | 55 · Aftercare only | $12.02 | $12.02 | $17.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $11.48 | Facility | 56 · Pre-op care only | $7.94 | $7.94 | $11.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $53.70 Typical High $57.54 | Professional | 52 · Reduced service | $39.81 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.22 Typical High $17.38 | Professional | 55 · Aftercare only | $12.02 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.72 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.94 | $10.72 | $11.48 |
Where Wisconsin sits
The same service costs 2.8 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
$148
AK $229DC $81.28
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.