How much rates vary
Facilitymedian $224 · 10th to 90th $141 to $447Professionalmedian $158 · 10th to 90th $141 to $282
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 $151.36 Median $151.36 Typical High $323.59 | Facility | None | $151.36 | $151.36 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $416.87 | Professional | None | $151.36 | $151.36 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $302.00 | Facility | None | $181.97 | $181.97 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $218.78 | Professional | None | $144.54 | $158.49 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $338.84 Typical High $446.68 | Facility | None | $208.93 | $338.84 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $257.04 | Professional | None | $144.54 | $186.21 | $257.04 |
DeanCare Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $309.03 | Facility | None | $141.25 | $141.25 | $309.03 |
DeanCare Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $281.84 | Professional | None | $213.80 | $281.84 | $281.84 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $309.03 | Facility | None | $141.25 | $141.25 | $309.03 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $208.93 | Professional | None | $141.25 | $154.88 | $208.93 |
Network Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Prevea360 Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $309.03 | Facility | None | $141.25 | $141.25 | $309.03 |
Prevea360 Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $281.84 | Professional | None | $213.80 | $281.84 | $281.84 |
Quartz Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $354.81 | Professional | None | $144.54 | $223.87 | $354.81 |
Quartz Setting Facility Modifier None Typical Low $194.98 Median $446.68 Typical High $446.68 | Facility | None | $194.98 | $446.68 | $446.68 |
Quartz Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Security Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $239.88 | Professional | None | $194.98 | $194.98 | $239.88 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $208.93 | Professional | None | $141.25 | $154.88 | $208.93 |
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 $74.13 Median $74.13 Typical High $208.93 | Professional | 52 · Reduced service | $74.13 | $74.13 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $83.18 | Professional | 53 · Discontinued | $30.20 | $30.20 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $61.66 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $41.69 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $41.69 |
Where Wisconsin sits
The same service costs 1.5 times more in Arizona than in Oregon. 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· 8th of 51
$166
AZ $219OR $145
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.