How much rates vary
Facilitymedian $170 · 10th to 90th $93 to $275Professionalmedian $102 · 10th to 90th $89 to $204
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 $93.33 Median $93.33 Typical High $213.80 | Facility | None | $93.33 | $93.33 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $489.78 | Professional | None | $93.33 | $93.33 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $199.53 | Facility | None | $112.20 | $112.20 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $114.82 | Professional | None | $89.13 | $100.00 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $239.88 Typical High $275.42 | Facility | None | $141.25 | $239.88 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $181.97 | Professional | None | $89.13 | $117.49 | $181.97 |
DeanCare Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $229.09 | Facility | None | $102.33 | $102.33 | $229.09 |
DeanCare Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $204.17 | Professional | None | $154.88 | $204.17 | $204.17 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $223.87 | Facility | None | $102.33 | $102.33 | $223.87 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $190.55 | Professional | None | $102.33 | $102.33 | $190.55 |
Network Health Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Prevea360 Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $229.09 | Facility | None | $102.33 | $102.33 | $229.09 |
Prevea360 Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $204.17 | Professional | None | $154.88 | $204.17 | $204.17 |
Quartz Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $269.15 | Professional | None | $89.13 | $147.91 | $269.15 |
Quartz Setting Facility Modifier None Typical Low $120.23 Median $275.42 Typical High $275.42 | Facility | None | $120.23 | $275.42 | $275.42 |
Quartz Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Security Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $147.91 | Professional | None | $120.23 | $120.23 | $147.91 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
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 $46.77 Median $46.77 Typical High $245.47 | Professional | 52 · Reduced service | $46.77 | $46.77 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $97.72 | Professional | 53 · Discontinued | $18.62 | $18.62 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $72.44 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $48.98 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $48.98 |
Where Wisconsin sits
The same service costs 5.9 times more in Alabama than in Florida. 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· 14th of 51
$105
AL $525FL $89.13
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.