How much rates vary
Facilitymedian $98 · 10th to 90th $50 to $191Professionalmedian $69 · 10th to 90th $62 to $115
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 $64.57 Median $64.57 Typical High $141.25 | Facility | None | $64.57 | $64.57 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $144.54 | Professional | None | $64.57 | $64.57 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $131.83 | Facility | None | $77.62 | $77.62 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $93.33 | Professional | None | $63.10 | $69.18 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $151.36 Typical High $190.55 | Facility | None | $97.72 | $151.36 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $114.82 | Professional | None | $63.10 | $72.44 | $114.82 |
DeanCare Setting Facility Modifier None Typical Low $32.36 Median $50.12 Typical High $50.12 | Facility | None | $32.36 | $50.12 | $50.12 |
DeanCare Setting Professional Modifier None Typical Low $17.38 Median $100.00 Typical High $100.00 | Professional | None | $17.38 | $100.00 | $100.00 |
Medica Setting Facility Modifier None Typical Low $32.36 Median $56.23 Typical High $56.23 | Facility | None | $32.36 | $56.23 | $56.23 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $63.10 Typical High $85.11 | Professional | None | $56.23 | $63.10 | $85.11 |
Network Health Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $63.10 | Facility | None | $60.26 | $63.10 | $63.10 |
Prevea360 Setting Facility Modifier None Typical Low $32.36 Median $50.12 Typical High $50.12 | Facility | None | $32.36 | $50.12 | $50.12 |
Prevea360 Setting Professional Modifier None Typical Low $17.38 Median $100.00 Typical High $100.00 | Professional | None | $17.38 | $100.00 | $100.00 |
Quartz Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $131.83 | Professional | None | $63.10 | $81.28 | $131.83 |
Quartz Setting Facility Modifier None Typical Low $102.33 Median $190.55 Typical High $190.55 | Facility | None | $102.33 | $190.55 | $190.55 |
Quartz Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Security Health Setting Professional Modifier None Typical Low $41.69 Median $85.11 Typical High $104.71 | Professional | None | $41.69 | $85.11 | $104.71 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $91.20 | Professional | None | $61.66 | $67.61 | $91.20 |
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 $32.36 Median $32.36 Typical High $70.79 | Professional | 52 · Reduced service | $32.36 | $32.36 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $28.84 | Professional | 53 · Discontinued | $12.88 | $12.88 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $21.38 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $14.45 |
Where Wisconsin sits
The same service costs 9.3 times more in Alabama 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· 11th of 51
$69.18
AL $525OK $56.23
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.