How much rates vary
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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $165.96 | Professional | None | $63.10 | $75.86 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $104.71 Typical High $151.36 | Facility | None | $91.20 | $104.71 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $107.15 | Professional | None | $85.11 | $85.11 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $257.04 Typical High $398.11 | Facility | None | $64.57 | $257.04 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $147.91 | Professional | None | $54.95 | $54.95 | $147.91 |
DeanCare Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $107.15 | Facility | None | $60.26 | $89.13 | $107.15 |
DeanCare Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | None | $93.33 | $93.33 | $97.72 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $93.33 Typical High $426.58 | Facility | None | $64.57 | $93.33 | $426.58 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $93.33 Typical High $478.63 | Professional | None | $47.86 | $93.33 | $478.63 |
Network Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $154.88 | Professional | None | $85.11 | $85.11 | $154.88 |
Prevea360 Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $107.15 | Facility | None | $60.26 | $89.13 | $107.15 |
Quartz Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $208.93 | Professional | None | $91.20 | $138.04 | $208.93 |
Quartz Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Quartz Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $64.57 | Professional | None | $54.95 | $54.95 | $64.57 |
United Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $123.03 | Professional | None | $32.36 | $48.98 | $123.03 |
5 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 $31.62 Median $38.02 Typical High $83.18 | Professional | 52 · Reduced service | $31.62 | $38.02 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $15.14 Typical High $33.11 | Professional | 53 · Discontinued | $12.59 | $15.14 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.22 Typical High $24.55 | Professional | 55 · Aftercare only | $9.55 | $11.22 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.59 Typical High $16.60 | Professional | 56 · Pre-op care only | $6.31 | $7.59 | $16.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $6.46 | Professional | RR · Rental | $5.37 | $5.37 | $6.46 |
Where Wisconsin sits
The same service costs 2.5 times more in Hawaii than in Rhode Island. 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· 12th of 51
$85.11
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.