How much rates vary
Facilitymedian $112 · 10th to 90th $83 to $355Professionalmedian $155 · 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 $83.18 Median $83.18 Typical High $112.20 | Facility | None | $83.18 | $83.18 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $213.80 | Professional | None | $83.18 | $112.20 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $309.03 | Professional | None | $102.33 | $173.78 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $165.96 | Professional | None | $107.15 | $138.04 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $354.81 Typical High $537.03 | Facility | None | $316.23 | $354.81 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $263.03 | Professional | None | $95.50 | $131.83 | $263.03 |
DeanCare Setting Facility Modifier None Typical Low $83.18 Median $112.20 Typical High $229.09 | Facility | None | $83.18 | $112.20 | $229.09 |
DeanCare Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $263.03 | Professional | None | $154.88 | $208.93 | $263.03 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $131.83 Typical High $239.88 | Facility | None | $89.13 | $131.83 | $239.88 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $457.09 Typical High $724.44 | Professional | None | $131.83 | $457.09 | $724.44 |
Network Health Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $234.42 | Professional | None | $169.82 | $194.98 | $234.42 |
Prevea360 Setting Facility Modifier None Typical Low $83.18 Median $112.20 Typical High $229.09 | Facility | None | $83.18 | $112.20 | $229.09 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $331.13 | Professional | None | $117.49 | $199.53 | $331.13 |
Quartz Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $158.49 | Professional | None | $95.50 | $128.82 | $158.49 |
Security Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | None | $144.54 | $144.54 | $194.98 |
Security Health Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $331.13 | Professional | None | $151.36 | $239.88 | $331.13 |
The Alliance Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $288.40 | Professional | None | $107.15 | $186.21 | $288.40 |
United Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $275.42 | Professional | None | $91.20 | $147.91 | $275.42 |
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 $41.69 Median $41.69 Typical High $56.23 | Facility | 52 · Reduced service | $41.69 | $41.69 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $16.98 | Facility | 55 · Aftercare only | $12.30 | $12.30 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $11.22 | Facility | 56 · Pre-op care only | $8.32 | $8.32 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $53.70 Typical High $58.88 | Professional | 52 · Reduced service | $41.69 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.85 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.72 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.32 | $10.72 | $11.75 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $204.17 Median $295.12 Typical High $363.08 | Professional | 25 · Same-day visit | $204.17 | $295.12 | $363.08 |
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· 7th of 51
$155
AK $224DC $83.18
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.