How much rates vary
Facilitymedian $95 · 10th to 90th $60 to $186Professionalmedian $68 · 10th to 90th $60 to $117
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 $63.10 Median $63.10 Typical High $138.04 | Facility | None | $63.10 | $63.10 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $251.19 | Professional | None | $63.10 | $63.10 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $128.82 | Facility | None | $75.86 | $75.86 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $91.20 | Professional | None | $61.66 | $67.61 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $95.50 Typical High $186.21 | Facility | None | $61.66 | $95.50 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $109.65 | Professional | None | $61.66 | $75.86 | $109.65 |
DeanCare Setting Facility Modifier None Typical Low $52.48 Median $58.88 Typical High $131.83 | Facility | None | $52.48 | $58.88 | $131.83 |
DeanCare Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $117.49 | Professional | None | $89.13 | $117.49 | $117.49 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $151.36 | Facility | None | $60.26 | $60.26 | $151.36 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $89.13 | Professional | None | $60.26 | $60.26 | $89.13 |
Network Health Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Prevea360 Setting Facility Modifier None Typical Low $52.48 Median $58.88 Typical High $131.83 | Facility | None | $52.48 | $58.88 | $131.83 |
Prevea360 Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $117.49 | Professional | None | $89.13 | $117.49 | $117.49 |
Quartz Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $154.88 | Professional | None | $61.66 | $95.50 | $154.88 |
Quartz Setting Facility Modifier None Typical Low $81.28 Median $186.21 Typical High $186.21 | Facility | None | $81.28 | $186.21 | $186.21 |
Quartz Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Security Health Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $102.33 | Professional | None | $60.26 | $83.18 | $102.33 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | None | $60.26 | $60.26 | $81.28 |
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 $31.62 Median $31.62 Typical High $125.89 | Professional | 52 · Reduced service | $31.62 | $31.62 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $50.12 | Professional | 53 · Discontinued | $12.59 | $12.59 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $37.15 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $25.12 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $25.12 |
Where Wisconsin sits
The same service costs 1.9 times more in Alaska than in Oklahoma. 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
$70.79
AK $110OK $57.54
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.