How much rates vary
Facilitymedian $132 · 10th to 90th $81 to $257Professionalmedian $93 · 10th to 90th $81 to $162
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 $87.10 Median $87.10 Typical High $186.21 | Facility | None | $87.10 | $87.10 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $269.15 | Professional | None | $87.10 | $87.10 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $173.78 | Facility | None | $104.71 | $104.71 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $107.15 | Professional | None | $83.18 | $93.33 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $257.04 | Facility | None | $83.18 | $138.04 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $151.36 | Professional | None | $83.18 | $95.50 | $151.36 |
DeanCare Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $177.83 | Facility | None | $81.28 | $81.28 | $177.83 |
DeanCare Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $162.18 | Professional | None | $120.23 | $162.18 | $162.18 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $177.83 | Facility | None | $81.28 | $81.28 | $177.83 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $120.23 | Professional | None | $81.28 | $81.28 | $120.23 |
Network Health Setting Facility Modifier None Typical Low $77.62 Median $81.28 Typical High $81.28 | Facility | None | $77.62 | $81.28 | $81.28 |
Prevea360 Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $177.83 | Facility | None | $81.28 | $81.28 | $177.83 |
Prevea360 Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $162.18 | Professional | None | $120.23 | $162.18 | $162.18 |
Quartz Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $204.17 | Professional | None | $83.18 | $128.82 | $204.17 |
Quartz Setting Facility Modifier None Typical Low $112.20 Median $257.04 Typical High $257.04 | Facility | None | $112.20 | $257.04 | $257.04 |
Quartz Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Security Health Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $138.04 | Professional | None | $112.20 | $112.20 | $138.04 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $112.20 | Professional | None | $81.28 | $81.28 | $112.20 |
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 $43.65 Median $43.65 Typical High $134.90 | Professional | 52 · Reduced service | $43.65 | $43.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $53.70 | Professional | 53 · Discontinued | $17.38 | $17.38 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $40.74 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $26.92 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $26.92 |
Where Wisconsin sits
The same service costs 1.5 times more in Arizona than in Nebraska. 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
$95.50
AZ $126NE $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.