How much rates vary
Facilitymedian $20 · 10th to 90th $13 to $41Professionalmedian $14 · 10th to 90th $13 to $26
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 $13.80 Median $13.80 Typical High $30.20 | Facility | None | $13.80 | $13.80 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $34.67 | Professional | None | $13.80 | $13.80 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $28.84 | Facility | None | $16.60 | $16.60 | $28.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $14.45 Typical High $16.98 | Professional | None | $13.18 | $14.45 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $32.36 Typical High $40.74 | Facility | None | $19.95 | $32.36 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $16.60 Typical High $24.55 | Professional | None | $13.18 | $16.60 | $24.55 |
DeanCare Setting Facility Modifier None Typical Low $10.96 Median $13.18 Typical High $13.18 | Facility | None | $10.96 | $13.18 | $13.18 |
DeanCare Setting Professional Modifier None Typical Low $6.17 Median $26.30 Typical High $26.30 | Professional | None | $6.17 | $26.30 | $26.30 |
Medica Setting Facility Modifier None Typical Low $10.96 Median $13.49 Typical High $13.49 | Facility | None | $10.96 | $13.49 | $13.49 |
Medica Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $19.95 | Professional | None | $13.49 | $13.49 | $19.95 |
Network Health Setting Facility Modifier None Typical Low $13.18 Median $14.45 Typical High $14.45 | Facility | None | $13.18 | $14.45 | $14.45 |
Prevea360 Setting Facility Modifier None Typical Low $10.96 Median $13.18 Typical High $13.18 | Facility | None | $10.96 | $13.18 | $13.18 |
Prevea360 Setting Professional Modifier None Typical Low $6.17 Median $26.30 Typical High $26.30 | Professional | None | $6.17 | $26.30 | $26.30 |
Quartz Setting Professional Modifier None Typical Low $13.18 Median $21.38 Typical High $33.88 | Professional | None | $13.18 | $21.38 | $33.88 |
Quartz Setting Facility Modifier None Typical Low $17.78 Median $40.74 Typical High $40.74 | Facility | None | $17.78 | $40.74 | $40.74 |
Quartz Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Security Health Setting Professional Modifier None Typical Low $12.88 Median $17.78 Typical High $21.88 | Professional | None | $12.88 | $17.78 | $21.88 |
United Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
United Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $18.20 | Professional | None | $13.18 | $13.18 | $18.20 |
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 $6.92 Median $6.92 Typical High $17.38 | Professional | 52 · Reduced service | $6.92 | $6.92 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $7.08 | Professional | 53 · Discontinued | $2.75 | $2.75 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $5.25 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.38 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.38 | $1.38 | $3.47 |
Where Wisconsin sits
The same service costs 1.5 times more in Alaska than in Delaware. 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· 11th of 51
$15.14
AK $19.95DE $13.18
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.