How much rates vary
Facilitymedian $115 · 10th to 90th $78 to $229Professionalmedian $85 · 10th to 90th $74 to $158
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 $77.62 Median $77.62 Typical High $173.78 | Facility | None | $77.62 | $77.62 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $190.55 | Professional | None | $77.62 | $77.62 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $162.18 | Facility | None | $93.33 | $93.33 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $112.20 | Professional | None | $74.13 | $83.18 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $186.21 Typical High $229.09 | Facility | None | $114.82 | $186.21 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $141.25 | Professional | None | $74.13 | $95.50 | $141.25 |
DeanCare Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $173.78 | Facility | None | $79.43 | $79.43 | $173.78 |
DeanCare Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $158.49 | Professional | None | $117.49 | $158.49 | $158.49 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $173.78 | Facility | None | $77.62 | $77.62 | $173.78 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $117.49 | Professional | None | $77.62 | $77.62 | $117.49 |
Network Health Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $87.10 | Facility | None | $85.11 | $85.11 | $87.10 |
Prevea360 Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $173.78 | Facility | None | $79.43 | $79.43 | $173.78 |
Prevea360 Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $158.49 | Professional | None | $117.49 | $158.49 | $158.49 |
Quartz Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $218.78 | Professional | None | $74.13 | $123.03 | $218.78 |
Quartz Setting Facility Modifier None Typical Low $100.00 Median $229.09 Typical High $229.09 | Facility | None | $100.00 | $229.09 | $229.09 |
Quartz Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Security Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $123.03 | Professional | None | $100.00 | $100.00 | $123.03 |
United Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $104.71 | Professional | None | $75.86 | $75.86 | $104.71 |
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 $38.90 Median $38.90 Typical High $95.50 | Professional | 52 · Reduced service | $38.90 | $38.90 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $38.02 | Professional | 53 · Discontinued | $15.49 | $15.49 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $28.18 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $19.05 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $19.05 |
Where Wisconsin sits
The same service costs 1.5 times more in Alaska than in Delaware. 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
$89.13
AK $115DE $74.13
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.