How much rates vary
Facilitymedian $98 · 10th to 90th $54 to $191Professionalmedian $63 · 10th to 90th $54 to $107
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 $131.83 | Facility | None | $64.57 | $64.57 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $77.62 | Professional | None | $63.10 | $64.57 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $93.33 | Professional | None | $63.10 | $63.10 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $141.25 Typical High $190.55 | Facility | None | $85.11 | $141.25 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
DeanCare Setting Facility Modifier None Typical Low $30.20 Median $57.54 Typical High $125.89 | Facility | None | $30.20 | $57.54 | $125.89 |
DeanCare Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $114.82 | Professional | None | $56.23 | $56.23 | $114.82 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $53.70 Typical High $117.49 | Facility | None | $30.20 | $53.70 | $117.49 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $309.03 | Professional | None | $53.70 | $67.61 | $309.03 |
Network Health Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Network Health Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $60.26 | Professional | None | $53.70 | $60.26 | $60.26 |
Prevea360 Setting Facility Modifier None Typical Low $30.20 Median $57.54 Typical High $125.89 | Facility | None | $30.20 | $57.54 | $125.89 |
Prevea360 Setting Professional Modifier None Typical Low $3.24 Median $114.82 Typical High $114.82 | Professional | None | $3.24 | $114.82 | $114.82 |
Quartz Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $144.54 | Professional | None | $61.66 | $91.20 | $144.54 |
Quartz Setting Facility Modifier None Typical Low $83.18 Median $190.55 Typical High $190.55 | Facility | None | $83.18 | $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 $37.15 Median $60.26 Typical High $87.10 | Professional | None | $37.15 | $60.26 | $87.10 |
United Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $77.62 | Professional | None | $57.54 | $57.54 | $77.62 |
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 $32.36 Typical High $38.90 | Professional | 52 · Reduced service | $31.62 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.88 Typical High $15.49 | Professional | 53 · Discontinued | $12.59 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $11.75 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.46 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.31 | $6.46 | $7.76 |
Where Wisconsin sits
Rates are fairly even across states for this service. 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· 31st of 51
$63.10
AK $72.44NC $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.