How much rates vary
Facilitymedian $174 · 10th to 90th $129 to $398Professionalmedian $145 · 10th to 90th $129 to $257
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 $134.90 Median $134.90 Typical High $295.12 | Facility | None | $134.90 | $134.90 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $446.68 | Professional | None | $134.90 | $134.90 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $281.84 | Facility | None | $162.18 | $162.18 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $165.96 | Professional | None | $128.82 | $144.54 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $199.53 Typical High $398.11 | Facility | None | $134.90 | $199.53 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $239.88 | Professional | None | $128.82 | $158.49 | $239.88 |
DeanCare Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $288.40 | Facility | None | $128.82 | $128.82 | $288.40 |
DeanCare Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | None | $194.98 | $257.04 | $257.04 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $288.40 | Facility | None | $128.82 | $128.82 | $288.40 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $194.98 | Professional | None | $128.82 | $128.82 | $194.98 |
Network Health Setting Facility Modifier None Typical Low $131.83 Median $134.90 Typical High $134.90 | Facility | None | $131.83 | $134.90 | $134.90 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $288.40 | Facility | None | $128.82 | $128.82 | $288.40 |
Prevea360 Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | None | $194.98 | $257.04 | $257.04 |
Quartz Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $331.13 | Professional | None | $128.82 | $208.93 | $331.13 |
Quartz Setting Facility Modifier None Typical Low $173.78 Median $398.11 Typical High $398.11 | Facility | None | $173.78 | $398.11 | $398.11 |
Quartz Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Security Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $213.80 | Professional | None | $173.78 | $173.78 | $213.80 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
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 $67.61 Median $67.61 Typical High $223.87 | Professional | 52 · Reduced service | $67.61 | $67.61 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $89.13 | Professional | 53 · Discontinued | $26.92 | $26.92 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $66.07 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $44.67 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $44.67 |
Where Wisconsin sits
The same service costs 1.6 times more in Texas than in North Carolina. 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· 10th of 51
$148
TX $204NC $129
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.