How much rates vary
Facilitymedian $204 · 10th to 90th $120 to $407Professionalmedian $148 · 10th to 90th $117 to $363
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 $120.23 Median $120.23 Typical High $338.84 | Facility | None | $120.23 | $120.23 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $660.69 | Professional | None | $120.23 | $120.23 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $316.23 | Facility | None | $147.91 | $147.91 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $147.91 | Professional | None | $117.49 | $128.82 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $354.81 Typical High $457.09 | Facility | None | $181.97 | $354.81 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $302.00 | Professional | None | $117.49 | $147.91 | $302.00 |
DeanCare Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $398.11 | Facility | None | $181.97 | $181.97 | $398.11 |
DeanCare Setting Professional Modifier None Typical Low $51.29 Median $363.08 Typical High $363.08 | Professional | None | $51.29 | $363.08 | $363.08 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $630.96 | Facility | None | $194.98 | $194.98 | $630.96 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $363.08 | Professional | None | $194.98 | $194.98 | $363.08 |
Network Health Setting Facility Modifier None Typical Low $186.21 Median $199.53 Typical High $199.53 | Facility | None | $186.21 | $199.53 | $199.53 |
Prevea360 Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $398.11 | Facility | None | $181.97 | $181.97 | $398.11 |
Prevea360 Setting Professional Modifier None Typical Low $51.29 Median $363.08 Typical High $363.08 | Professional | None | $51.29 | $363.08 | $363.08 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $239.88 Typical High $467.74 | Professional | None | $117.49 | $239.88 | $467.74 |
Quartz Setting Facility Modifier None Typical Low $154.88 Median $354.81 Typical High $354.81 | Facility | None | $154.88 | $354.81 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Security Health Setting Professional Modifier None Typical Low $158.49 Median $162.18 Typical High $288.40 | Professional | None | $158.49 | $162.18 | $288.40 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $199.53 | Professional | None | $147.91 | $147.91 | $199.53 |
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 $60.26 Median $60.26 Typical High $331.13 | Professional | 52 · Reduced service | $60.26 | $60.26 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $131.83 | Professional | 53 · Discontinued | $23.99 | $23.99 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $97.72 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $66.07 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $66.07 |
Where Wisconsin sits
The same service costs 2.0 times more in Kansas than in Georgia. 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· 33rd of 51
$148
KS $234GA $117
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.