How much rates vary
Facilitymedian $68 · 10th to 90th $42 to $132Professionalmedian $48 · 10th to 90th $43 to $83
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 $44.67 Median $44.67 Typical High $97.72 | Facility | None | $44.67 | $44.67 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $147.91 | Professional | None | $44.67 | $44.67 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $91.20 | Facility | None | $54.95 | $54.95 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $54.95 | Professional | None | $43.65 | $47.86 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $72.44 Typical High $131.83 | Facility | None | $43.65 | $72.44 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $79.43 | Professional | None | $43.65 | $50.12 | $79.43 |
DeanCare Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $93.33 | Facility | None | $41.69 | $41.69 | $93.33 |
DeanCare Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $83.18 | Professional | None | $63.10 | $83.18 | $83.18 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $93.33 | Facility | None | $41.69 | $41.69 | $93.33 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $63.10 | Professional | None | $41.69 | $41.69 | $63.10 |
Network Health Setting Facility Modifier None Typical Low $40.74 Median $42.66 Typical High $42.66 | Facility | None | $40.74 | $42.66 | $42.66 |
Prevea360 Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $93.33 | Facility | None | $41.69 | $41.69 | $93.33 |
Prevea360 Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $83.18 | Professional | None | $63.10 | $83.18 | $83.18 |
Quartz Setting Professional Modifier None Typical Low $43.65 Median $67.61 Typical High $107.15 | Professional | None | $43.65 | $67.61 | $107.15 |
Quartz Setting Facility Modifier None Typical Low $72.44 Median $131.83 Typical High $131.83 | Facility | None | $72.44 | $131.83 | $131.83 |
Quartz Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Security Health Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $72.44 | Professional | None | $58.88 | $58.88 | $72.44 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $58.88 | Professional | None | $42.66 | $42.66 | $58.88 |
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 $22.39 Median $22.39 Typical High $74.13 | Professional | 52 · Reduced service | $22.39 | $22.39 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $29.51 | Professional | 53 · Discontinued | $8.91 | $8.91 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $21.88 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $14.79 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $14.79 |
Where Wisconsin sits
The same service costs 1.6 times more in Arizona than in Maryland. 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
$48.98
AZ $69.18MD $42.66
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.