How much rates vary
Facilitymedian $110 · 10th to 90th $79 to $347Professionalmedian $151 · 10th to 90th $85 to $331
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 $109.65 | Facility | None | $79.43 | $79.43 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $144.54 | Professional | None | $79.43 | $104.71 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $295.12 | Professional | None | $100.00 | $169.82 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $158.49 | Professional | None | $104.71 | $134.90 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $346.74 Typical High $512.86 | Facility | None | $302.00 | $346.74 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $251.19 | Professional | None | $91.20 | $128.82 | $251.19 |
DeanCare Setting Facility Modifier None Typical Low $81.28 Median $109.65 Typical High $223.87 | Facility | None | $81.28 | $109.65 | $223.87 |
DeanCare Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $257.04 | Professional | None | $147.91 | $204.17 | $257.04 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $223.87 | Facility | None | $81.28 | $114.82 | $223.87 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $524.81 Typical High $724.44 | Professional | None | $128.82 | $524.81 | $724.44 |
Network Health Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $229.09 | Professional | None | $162.18 | $190.55 | $229.09 |
Prevea360 Setting Facility Modifier None Typical Low $81.28 Median $109.65 Typical High $223.87 | Facility | None | $81.28 | $109.65 | $223.87 |
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 $190.55 | Professional | None | $141.25 | $141.25 | $190.55 |
Security Health Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $323.59 | Professional | None | $144.54 | $234.42 | $323.59 |
The Alliance Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $281.84 | Professional | None | $109.65 | $194.98 | $281.84 |
United Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $269.15 | Professional | None | $89.13 | $144.54 | $269.15 |
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 $39.81 Median $39.81 Typical High $54.95 | Facility | 52 · Reduced service | $39.81 | $39.81 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $16.60 | Facility | 55 · Aftercare only | $12.02 | $12.02 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $10.96 | Facility | 56 · Pre-op care only | $7.94 | $7.94 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $50.12 Typical High $54.95 | Professional | 52 · Reduced service | $39.81 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.79 Typical High $16.60 | Professional | 55 · Aftercare only | $12.02 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.94 | $10.00 | $10.96 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $199.53 Median $288.40 Typical High $331.13 | Professional | 25 · Same-day visit | $199.53 | $288.40 | $331.13 |
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
$148
AK $219DC $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.