How much rates vary
Facilitymedian $105 · 10th to 90th $69 to $204Professionalmedian $78 · 10th to 90th $68 to $151
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 $69.18 Median $69.18 Typical High $154.88 | Facility | None | $69.18 | $69.18 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $338.84 | Professional | None | $69.18 | $69.18 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $144.54 | Facility | None | $83.18 | $83.18 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $100.00 | Professional | None | $67.61 | $74.13 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $177.83 Typical High $204.17 | Facility | None | $104.71 | $177.83 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $134.90 | Professional | None | $67.61 | $87.10 | $134.90 |
DeanCare Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $165.96 | Facility | None | $75.86 | $75.86 | $165.96 |
DeanCare Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $151.36 | Professional | None | $114.82 | $151.36 | $151.36 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $165.96 | Facility | None | $74.13 | $74.13 | $165.96 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $125.89 | Professional | None | $74.13 | $74.13 | $125.89 |
Network Health Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $85.11 | Facility | None | $77.62 | $77.62 | $85.11 |
Prevea360 Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $165.96 | Facility | None | $75.86 | $75.86 | $165.96 |
Prevea360 Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $151.36 | Professional | None | $114.82 | $151.36 | $151.36 |
Quartz Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $199.53 | Professional | None | $67.61 | $107.15 | $199.53 |
Quartz Setting Facility Modifier None Typical Low $89.13 Median $204.17 Typical High $204.17 | Facility | None | $89.13 | $204.17 | $204.17 |
Quartz Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Security Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | None | $91.20 | $91.20 | $112.20 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $93.33 | Professional | None | $67.61 | $67.61 | $93.33 |
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 $34.67 Median $34.67 Typical High $169.82 | Professional | 52 · Reduced service | $34.67 | $34.67 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $67.61 | Professional | 53 · Discontinued | $13.80 | $13.80 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $50.12 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $33.88 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $33.88 |
Where Wisconsin sits
The same service costs 2.0 times more in Oklahoma than in New Mexico. 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· 12th of 51
$79.43
OK $135NM $67.61
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.