How much rates vary
Facilitymedian $145 · 10th to 90th $110 to $457Professionalmedian $200 · 10th to 90th $115 to $437
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 $109.65 Median $109.65 Typical High $144.54 | Facility | None | $109.65 | $109.65 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $218.78 | Professional | None | $109.65 | $134.90 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $398.11 | Professional | None | $134.90 | $229.09 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $208.93 | Professional | None | $138.04 | $177.83 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $457.09 Typical High $676.08 | Facility | None | $398.11 | $457.09 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $331.13 | Professional | None | $125.89 | $165.96 | $331.13 |
DeanCare Setting Facility Modifier None Typical Low $109.65 Median $144.54 Typical High $295.12 | Facility | None | $109.65 | $144.54 | $295.12 |
DeanCare Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $338.84 | Professional | None | $204.17 | $269.15 | $338.84 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $151.36 Typical High $309.03 | Facility | None | $109.65 | $151.36 | $309.03 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $446.68 Typical High $954.99 | Professional | None | $158.49 | $446.68 | $954.99 |
Network Health Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $309.03 | Professional | None | $223.87 | $251.19 | $309.03 |
Prevea360 Setting Facility Modifier None Typical Low $109.65 Median $144.54 Typical High $295.12 | Facility | None | $109.65 | $144.54 | $295.12 |
Quartz Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $426.58 | Professional | None | $154.88 | $269.15 | $426.58 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $204.17 | Professional | None | $125.89 | $165.96 | $204.17 |
Security Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $251.19 | Professional | None | $194.98 | $194.98 | $251.19 |
Security Health Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $426.58 | Professional | None | $199.53 | $263.03 | $426.58 |
The Alliance Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $371.54 | Professional | None | $144.54 | $251.19 | $371.54 |
United Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $354.81 | Professional | None | $123.03 | $194.98 | $354.81 |
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 $54.95 Median $54.95 Typical High $72.44 | Facility | 52 · Reduced service | $54.95 | $54.95 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $21.88 | Facility | 55 · Aftercare only | $16.22 | $16.22 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $14.45 | Facility | 56 · Pre-op care only | $10.96 | $10.96 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $67.61 Typical High $75.86 | Professional | 52 · Reduced service | $54.95 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.42 Typical High $22.39 | Professional | 55 · Aftercare only | $16.22 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.49 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.96 | $13.49 | $15.14 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $302.00 Median $389.05 Typical High $467.74 | Professional | 25 · Same-day visit | $302.00 | $389.05 | $467.74 |
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· 8th of 51
$195
AK $295DC $110
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.