How much rates vary
Facilitymedian $126 · 10th to 90th $91 to $398Professionalmedian $166 · 10th to 90th $98 to $380
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 $91.20 Median $91.20 Typical High $125.89 | Facility | None | $91.20 | $91.20 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $169.82 | Professional | None | $91.20 | $117.49 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $338.84 | Professional | None | $112.20 | $190.55 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $181.97 | Professional | None | $117.49 | $154.88 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $398.11 Typical High $588.84 | Facility | None | $346.74 | $398.11 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $288.40 | Professional | None | $104.71 | $144.54 | $288.40 |
DeanCare Setting Facility Modifier None Typical Low $91.20 Median $125.89 Typical High $257.04 | Facility | None | $91.20 | $125.89 | $257.04 |
DeanCare Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $295.12 | Professional | None | $169.82 | $229.09 | $295.12 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $144.54 Typical High $257.04 | Facility | None | $91.20 | $144.54 | $257.04 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $407.38 Typical High $812.83 | Professional | None | $138.04 | $407.38 | $812.83 |
Network Health Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $257.04 | Professional | None | $186.21 | $218.78 | $257.04 |
Prevea360 Setting Facility Modifier None Typical Low $91.20 Median $125.89 Typical High $257.04 | Facility | None | $91.20 | $125.89 | $257.04 |
Quartz Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $371.54 | Professional | None | $128.82 | $218.78 | $371.54 |
Quartz Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $173.78 | Professional | None | $104.71 | $138.04 | $173.78 |
Security Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Security Health Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $363.08 | Professional | None | $165.96 | $257.04 | $363.08 |
The Alliance Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $316.23 | Professional | None | $117.49 | $204.17 | $316.23 |
United Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $309.03 | Professional | None | $104.71 | $162.18 | $309.03 |
7 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 $44.67 Median $44.67 Typical High $63.10 | Facility | 52 · Reduced service | $44.67 | $44.67 | $63.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $19.05 | Facility | 55 · Aftercare only | $13.49 | $13.49 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $12.59 | Facility | 56 · Pre-op care only | $9.12 | $9.12 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $58.88 Typical High $63.10 | Professional | 52 · Reduced service | $44.67 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $17.78 Typical High $19.05 | Professional | 55 · Aftercare only | $13.49 | $17.78 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.75 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.12 | $11.75 | $12.59 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $229.09 Median $316.23 Typical High $398.11 | Professional | 25 · Same-day visit | $229.09 | $316.23 | $398.11 |
Where Wisconsin sits
The same service costs 2.7 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
$166
AK $251DC $93.33
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.