How much rates vary
Facilitymedian $457 · 10th to 90th $195 to $891Professionalmedian $295 · 10th to 90th $214 to $562
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 $302.00 Median $302.00 Typical High $489.78 | Facility | None | $302.00 | $302.00 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $512.86 | Professional | None | $302.00 | $302.00 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $457.09 | Facility | None | $371.54 | $371.54 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $446.68 | Professional | None | $295.12 | $323.59 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $851.14 Typical High $954.99 | Facility | None | $457.09 | $851.14 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $630.96 | Professional | None | $295.12 | $380.19 | $630.96 |
DeanCare Setting Facility Modifier None Typical Low $70.79 Median $295.12 Typical High $645.65 | Facility | None | $70.79 | $295.12 | $645.65 |
DeanCare Setting Professional Modifier None Typical Low $1.86 Median $588.84 Typical High $588.84 | Professional | None | $1.86 | $588.84 | $588.84 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $194.98 Typical High $426.58 | Facility | None | $70.79 | $194.98 | $426.58 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $446.68 | Professional | None | $194.98 | $194.98 | $446.68 |
Network Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Prevea360 Setting Facility Modifier None Typical Low $70.79 Median $295.12 Typical High $645.65 | Facility | None | $70.79 | $295.12 | $645.65 |
Prevea360 Setting Professional Modifier None Typical Low $1.86 Median $588.84 Typical High $588.84 | Professional | None | $1.86 | $588.84 | $588.84 |
Quartz Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $741.31 | Professional | None | $275.42 | $346.74 | $741.31 |
Quartz Setting Facility Modifier None Typical Low $389.05 Median $891.25 Typical High $891.25 | Facility | None | $389.05 | $891.25 | $891.25 |
Quartz Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Security Health Setting Professional Modifier None Typical Low $81.28 Median $398.11 Typical High $489.78 | Professional | None | $81.28 | $398.11 | $489.78 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
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 $151.36 Median $151.36 Typical High $257.04 | Professional | 52 · Reduced service | $151.36 | $151.36 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $102.33 | Professional | 53 · Discontinued | $60.26 | $60.26 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $77.62 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $51.29 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $51.29 |
Where Wisconsin sits
The same service costs 6.8 times more in Wyoming 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· 14th of 51
$302
WY $457OK $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.