How much rates vary
Facilitymedian $83 · 10th to 90th $68 to $257Professionalmedian $123 · 10th to 90th $76 to $257
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 $67.61 Median $67.61 Typical High $83.18 | Facility | None | $67.61 | $67.61 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $102.33 | Professional | None | $67.61 | $83.18 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $229.09 | Professional | None | $83.18 | $138.04 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $257.04 Typical High $389.05 | Facility | None | $229.09 | $257.04 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $199.53 | Professional | None | $79.43 | $95.50 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $69.18 Median $83.18 Typical High $173.78 | Facility | None | $69.18 | $83.18 | $173.78 |
DeanCare Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $194.98 | Professional | None | $125.89 | $154.88 | $194.98 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $83.18 Typical High $173.78 | Facility | None | $69.18 | $83.18 | $173.78 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $446.68 Typical High $549.54 | Professional | None | $104.71 | $446.68 | $549.54 |
Network Health Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $181.97 | Professional | None | $141.25 | $158.49 | $181.97 |
Prevea360 Setting Facility Modifier None Typical Low $69.18 Median $83.18 Typical High $173.78 | Facility | None | $69.18 | $83.18 | $173.78 |
Quartz Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $239.88 | Professional | None | $93.33 | $158.49 | $239.88 |
Quartz Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $114.82 | Professional | None | $79.43 | $95.50 | $114.82 |
Security Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | None | $120.23 | $120.23 | $144.54 |
Security Health Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $257.04 | Professional | None | $109.65 | $204.17 | $257.04 |
The Alliance Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $218.78 | Professional | None | $120.23 | $177.83 | $218.78 |
United Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $204.17 | Professional | None | $81.28 | $123.03 | $204.17 |
6 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 $33.88 Median $33.88 Typical High $41.69 | Facility | 52 · Reduced service | $33.88 | $33.88 | $41.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $12.30 | Facility | 55 · Aftercare only | $10.23 | $10.23 | $12.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $8.32 | Facility | 56 · Pre-op care only | $6.92 | $6.92 | $8.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $39.81 Typical High $42.66 | Professional | 52 · Reduced service | $33.88 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.02 Typical High $12.88 | Professional | 55 · Aftercare only | $10.23 | $12.02 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.94 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.92 | $7.94 | $8.51 |
Where Wisconsin sits
The same service costs 2.9 times more in Alaska than in Florida. 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
$123
AK $186FL $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.