How much rates vary
Facilitymedian $74 · 10th to 90th $40 to $117Professionalmedian $45 · 10th to 90th $38 to $100
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 $40.74 Median $40.74 Typical High $91.20 | Facility | None | $40.74 | $40.74 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $154.88 | Professional | None | $40.74 | $40.74 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $79.43 Typical High $89.13 | Facility | None | $74.13 | $79.43 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.90 Typical High $109.65 | Professional | None | $38.02 | $38.90 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $97.72 Typical High $117.49 | Facility | None | $58.88 | $97.72 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $74.13 | Professional | None | $38.90 | $51.29 | $74.13 |
DeanCare Setting Facility Modifier None Typical Low $37.15 Median $39.81 Typical High $87.10 | Facility | None | $37.15 | $39.81 | $87.10 |
DeanCare Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | None | $60.26 | $79.43 | $79.43 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $87.10 | Facility | None | $39.81 | $39.81 | $87.10 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $60.26 | Professional | None | $39.81 | $39.81 | $60.26 |
Network Health Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Prevea360 Setting Facility Modifier None Typical Low $37.15 Median $39.81 Typical High $87.10 | Facility | None | $37.15 | $39.81 | $87.10 |
Prevea360 Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | None | $60.26 | $79.43 | $79.43 |
Quartz Setting Professional Modifier None Typical Low $39.81 Median $63.10 Typical High $104.71 | Professional | None | $39.81 | $63.10 | $104.71 |
Quartz Setting Facility Modifier None Typical Low $51.29 Median $117.49 Typical High $117.49 | Facility | None | $51.29 | $117.49 | $117.49 |
Quartz Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Security Health Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $66.07 | Professional | None | $42.66 | $53.70 | $66.07 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
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 $20.42 Median $20.42 Typical High $77.62 | Professional | 52 · Reduced service | $20.42 | $20.42 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $30.90 | Professional | 53 · Discontinued | $8.13 | $8.13 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $23.44 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $15.49 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $15.49 |
Where Wisconsin sits
The same service costs 1.6 times more in Arizona than in Wyoming. 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
$46.77
AZ $63.10WY $38.90
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.