How much rates vary
Facilitymedian $95 · 10th to 90th $65 to $302Professionalmedian $126 · 10th to 90th $68 to $288
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 $64.57 Median $64.57 Typical High $95.50 | Facility | None | $64.57 | $64.57 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $120.23 | Professional | None | $64.57 | $89.13 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $257.04 | Professional | None | $79.43 | $138.04 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $138.04 | Professional | None | $89.13 | $114.82 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $302.00 Typical High $446.68 | Facility | None | $263.03 | $302.00 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $218.78 | Professional | None | $74.13 | $109.65 | $218.78 |
DeanCare Setting Facility Modifier None Typical Low $64.57 Median $95.50 Typical High $194.98 | Facility | None | $64.57 | $95.50 | $194.98 |
DeanCare Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $223.87 | Professional | None | $120.23 | $173.78 | $223.87 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $95.50 Typical High $194.98 | Facility | None | $64.57 | $95.50 | $194.98 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $426.58 Typical High $616.60 | Professional | None | $107.15 | $426.58 | $616.60 |
Network Health Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $194.98 | Professional | None | $138.04 | $162.18 | $194.98 |
Prevea360 Setting Facility Modifier None Typical Low $64.57 Median $95.50 Typical High $194.98 | Facility | None | $64.57 | $95.50 | $194.98 |
Quartz Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $269.15 | Professional | None | $91.20 | $154.88 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $131.83 | Professional | None | $74.13 | $97.72 | $131.83 |
Security Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | None | $102.33 | $102.33 | $147.91 |
Security Health Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $275.42 | Professional | None | $97.72 | $169.82 | $275.42 |
The Alliance Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $234.42 | Professional | None | $87.10 | $154.88 | $234.42 |
United Setting Professional Modifier None Typical Low $72.44 Median $117.49 Typical High $234.42 | Professional | None | $72.44 | $117.49 | $234.42 |
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 $32.36 Median $32.36 Typical High $47.86 | Facility | 52 · Reduced service | $32.36 | $32.36 | $47.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $14.13 | Facility | 55 · Aftercare only | $9.55 | $9.55 | $14.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $9.55 | Facility | 56 · Pre-op care only | $6.46 | $6.46 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $44.67 Typical High $47.86 | Professional | 52 · Reduced service | $32.36 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $13.49 Typical High $14.13 | Professional | 55 · Aftercare only | $9.55 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.91 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.46 | $8.91 | $9.55 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $177.83 Median $251.19 Typical High $295.12 | Professional | 25 · Same-day visit | $177.83 | $251.19 | $295.12 |
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· 7th of 51
$126
AK $186DC $64.57
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.