How much rates vary
Facilitymedian $501 · 10th to 90th $309 to $977Professionalmedian $355 · 10th to 90th $309 to $575
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 $331.13 Median $331.13 Typical High $724.44 | Facility | None | $331.13 | $331.13 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $676.08 | Facility | None | $398.11 | $398.11 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $407.38 | Professional | None | $316.23 | $354.81 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $977.24 | Facility | None | $323.59 | $524.81 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $575.44 | Professional | None | $316.23 | $371.54 | $575.44 |
DeanCare Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $676.08 | Facility | None | $309.03 | $309.03 | $676.08 |
DeanCare Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $616.60 | Professional | None | $467.74 | $616.60 | $616.60 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $676.08 | Facility | None | $309.03 | $309.03 | $676.08 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $457.09 | Professional | None | $309.03 | $309.03 | $457.09 |
Network Health Setting Facility Modifier None Typical Low $275.42 Median $295.12 Typical High $295.12 | Facility | None | $275.42 | $295.12 | $295.12 |
Prevea360 Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $676.08 | Facility | None | $309.03 | $309.03 | $676.08 |
Prevea360 Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $616.60 | Professional | None | $467.74 | $616.60 | $616.60 |
Quartz Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $794.33 | Professional | None | $316.23 | $501.19 | $794.33 |
Quartz Setting Facility Modifier None Typical Low $426.58 Median $977.24 Typical High $977.24 | Facility | None | $426.58 | $977.24 | $977.24 |
Quartz Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Security Health Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $524.81 | Professional | None | $426.58 | $426.58 | $524.81 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
United Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | None | $309.03 | $309.03 | $426.58 |
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 $165.96 Median $165.96 Typical High $223.87 | Professional | 52 · Reduced service | $165.96 | $165.96 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | 53 · Discontinued | $66.07 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $44.67 |
Where Wisconsin sits
The same service costs 1.6 times more in Arizona than in Rhode Island. 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· 7th of 51
$363
AZ $501RI $309
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.