How much rates vary
Facilitymedian $32 · 10th to 90th $21 to $65Professionalmedian $23 · 10th to 90th $21 to $44
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 $21.88 Median $21.88 Typical High $50.12 | Facility | None | $21.88 | $21.88 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $134.90 | Professional | None | $21.88 | $21.88 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $46.77 | Facility | None | $26.30 | $26.30 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $26.92 | Professional | None | $20.89 | $23.44 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $56.23 Typical High $64.57 | Facility | None | $32.36 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $26.92 Typical High $42.66 | Professional | None | $20.89 | $26.92 | $42.66 |
DeanCare Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $48.98 | Facility | None | $21.88 | $21.88 | $48.98 |
DeanCare Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $43.65 | Professional | None | $33.11 | $43.65 | $43.65 |
Medica Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $41.69 | Facility | None | $19.05 | $19.05 | $41.69 |
Medica Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $41.69 | Professional | None | $19.05 | $19.05 | $41.69 |
Network Health Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $23.99 | Facility | None | $19.95 | $19.95 | $23.99 |
Prevea360 Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $48.98 | Facility | None | $21.88 | $21.88 | $48.98 |
Prevea360 Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $43.65 | Professional | None | $33.11 | $43.65 | $43.65 |
Quartz Setting Professional Modifier None Typical Low $20.89 Median $34.67 Typical High $64.57 | Professional | None | $20.89 | $34.67 | $64.57 |
Quartz Setting Facility Modifier None Typical Low $28.18 Median $64.57 Typical High $64.57 | Facility | None | $28.18 | $64.57 | $64.57 |
Quartz Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Security Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | None | $28.18 | $28.18 | $34.67 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
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 $10.96 Median $10.96 Typical High $67.61 | Professional | 52 · Reduced service | $10.96 | $10.96 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $26.92 | Professional | 53 · Discontinued | $4.37 | $4.37 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $20.42 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $13.49 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $13.49 |
Where Wisconsin sits
The same service costs 2.6 times more in Wyoming than in Texas. 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
$23.99
WY $38.90TX $14.79
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.