How much rates vary
Facilitymedian $28 · 10th to 90th $18 to $56Professionalmedian $20 · 10th to 90th $18 to $36
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 $19.05 Median $19.05 Typical High $41.69 | Facility | None | $19.05 | $19.05 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $61.66 | Professional | None | $19.05 | $19.05 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $39.81 | Facility | None | $22.91 | $22.91 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $23.44 | Professional | None | $18.62 | $20.42 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $28.84 Typical High $56.23 | Facility | None | $18.62 | $28.84 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $33.88 | Professional | None | $18.62 | $21.88 | $33.88 |
DeanCare Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $39.81 | Facility | None | $18.20 | $18.20 | $39.81 |
DeanCare Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $36.31 | Professional | None | $26.92 | $36.31 | $36.31 |
Medica Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $40.74 | Facility | None | $18.20 | $18.20 | $40.74 |
Medica Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $26.92 | Professional | None | $18.20 | $18.20 | $26.92 |
Network Health Setting Facility Modifier None Typical Low $17.38 Median $18.20 Typical High $18.20 | Facility | None | $17.38 | $18.20 | $18.20 |
Prevea360 Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $39.81 | Facility | None | $18.20 | $18.20 | $39.81 |
Prevea360 Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $36.31 | Professional | None | $26.92 | $36.31 | $36.31 |
Quartz Setting Professional Modifier None Typical Low $18.62 Median $29.51 Typical High $45.71 | Professional | None | $18.62 | $29.51 | $45.71 |
Quartz Setting Facility Modifier None Typical Low $24.55 Median $56.23 Typical High $56.23 | Facility | None | $24.55 | $56.23 | $56.23 |
Quartz Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Security Health Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $30.90 | Professional | None | $25.12 | $25.12 | $30.90 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $25.12 | Professional | None | $18.20 | $18.20 | $25.12 |
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 $9.55 Median $9.55 Typical High $30.90 | Professional | 52 · Reduced service | $9.55 | $9.55 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $12.30 | Professional | 53 · Discontinued | $3.80 | $3.80 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $9.33 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $6.17 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $6.17 |
Where Wisconsin sits
The same service costs 1.5 times more in Alaska 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· 7th of 51
$21.38
AK $27.54RI $18.20
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.