How much rates vary
Facilitymedian $49 · 10th to 90th $35 to $120Professionalmedian $41 · 10th to 90th $15 to $66
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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $52.48 | Professional | None | $24.55 | $30.90 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $48.98 Typical High $72.44 | Facility | None | $43.65 | $48.98 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | None | $40.74 | $40.74 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $138.04 Typical High $204.17 | Facility | None | $120.23 | $138.04 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $44.67 Typical High $74.13 | Professional | None | $21.88 | $44.67 | $74.13 |
DeanCare Setting Facility Modifier None Typical Low $25.12 Median $43.65 Typical High $45.71 | Facility | None | $25.12 | $43.65 | $45.71 |
DeanCare Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $47.86 | Professional | None | $37.15 | $40.74 | $47.86 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $43.65 Typical High $87.10 | Facility | None | $25.12 | $43.65 | $87.10 |
Medica Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $213.80 | Professional | None | $15.14 | $15.14 | $213.80 |
Network Health Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Network Health Setting Professional Modifier None Typical Low $38.02 Median $40.74 Typical High $74.13 | Professional | None | $38.02 | $40.74 | $74.13 |
Prevea360 Setting Facility Modifier None Typical Low $25.12 Median $43.65 Typical High $45.71 | Facility | None | $25.12 | $43.65 | $45.71 |
Prevea360 Setting Professional Modifier None Typical Low $24.55 Median $43.65 Typical High $43.65 | Professional | None | $24.55 | $43.65 | $43.65 |
Quartz Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $93.33 | Professional | None | $40.74 | $66.07 | $93.33 |
Quartz Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Security Health Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Security Health Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $57.54 | Professional | None | $43.65 | $43.65 | $57.54 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $20.42 | Professional | None | $15.14 | $15.14 | $20.42 |
4 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 Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $25.70 | Professional | 52 · Reduced service | $15.49 | $15.49 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $10.47 | Professional | 53 · Discontinued | $6.17 | $6.17 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $7.76 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $5.25 |
Where Wisconsin sits
The same service costs 3.2 times more in Hawaii than in Utah. 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· 10th of 51
$40.74
HI $47.86UT $15.14
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.