How much rates vary
Facilitymedian $112 · 10th to 90th $69 to $224Professionalmedian $83 · 10th to 90th $72 to $178
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 $75.86 Median $75.86 Typical High $169.82 | Facility | None | $75.86 | $75.86 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $501.19 | Professional | None | $75.86 | $75.86 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $213.80 | Professional | None | $72.44 | $83.18 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $194.98 Typical High $223.87 | Facility | None | $112.20 | $194.98 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $95.50 | Professional | None | $72.44 | $83.18 | $95.50 |
DeanCare Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $154.88 | Facility | None | $69.18 | $69.18 | $154.88 |
DeanCare Setting Professional Modifier None Typical Low $33.11 Median $138.04 Typical High $138.04 | Professional | None | $33.11 | $138.04 | $138.04 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $181.97 | Facility | None | $83.18 | $83.18 | $181.97 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $83.18 Typical High $138.04 | Professional | None | $33.11 | $83.18 | $138.04 |
Network Health Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Network Health Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | None | $75.86 | $83.18 | $95.50 |
Prevea360 Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $154.88 | Facility | None | $69.18 | $69.18 | $154.88 |
Prevea360 Setting Professional Modifier None Typical Low $33.11 Median $138.04 Typical High $138.04 | Professional | None | $33.11 | $138.04 | $138.04 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $117.49 Typical High $213.80 | Professional | None | $72.44 | $117.49 | $213.80 |
Quartz Setting Facility Modifier None Typical Low $97.72 Median $223.87 Typical High $223.87 | Facility | None | $97.72 | $223.87 | $223.87 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Security Health Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $138.04 | Professional | None | $97.72 | $117.49 | $138.04 |
United Setting Professional Modifier None Typical Low $29.51 Median $74.13 Typical High $100.00 | Professional | None | $29.51 | $74.13 | $100.00 |
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 $38.02 Median $38.02 Typical High $251.19 | Professional | 52 · Reduced service | $38.02 | $38.02 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $100.00 | Professional | 53 · Discontinued | $15.14 | $15.14 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $75.86 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $50.12 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $50.12 |
Where Wisconsin sits
The same service costs 1.6 times more in Hawaii than in Virginia. 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· 9th of 51
$83.18
HI $115VA $72.44
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.