How much rates vary
Facilitymedian $32 · 10th to 90th $22 to $66Professionalmedian $24 · 10th to 90th $21 to $43
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 $22.39 Median $22.39 Typical High $47.86 | Facility | None | $22.39 | $22.39 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $93.33 | Professional | None | $22.39 | $22.39 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $44.67 | Facility | None | $26.92 | $26.92 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $23.99 Typical High $32.36 | Professional | None | $21.38 | $23.99 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $33.88 Typical High $66.07 | Facility | None | $21.88 | $33.88 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $27.54 Typical High $39.81 | Professional | None | $21.38 | $27.54 | $39.81 |
DeanCare Setting Facility Modifier None Typical Low $18.62 Median $21.38 Typical High $46.77 | Facility | None | $18.62 | $21.38 | $46.77 |
DeanCare Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $42.66 | Professional | None | $31.62 | $42.66 | $42.66 |
Medica Setting Facility Modifier None Typical Low $21.88 Median $31.62 Typical High $69.18 | Facility | None | $21.88 | $31.62 | $69.18 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $37.15 | Professional | None | $21.88 | $21.88 | $37.15 |
Network Health Setting Facility Modifier None Typical Low $22.91 Median $23.44 Typical High $23.44 | Facility | None | $22.91 | $23.44 | $23.44 |
Prevea360 Setting Facility Modifier None Typical Low $18.62 Median $21.38 Typical High $46.77 | Facility | None | $18.62 | $21.38 | $46.77 |
Prevea360 Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $42.66 | Professional | None | $31.62 | $42.66 | $42.66 |
Quartz Setting Professional Modifier None Typical Low $21.38 Median $33.88 Typical High $56.23 | Professional | None | $21.38 | $33.88 | $56.23 |
Quartz Setting Facility Modifier None Typical Low $28.84 Median $66.07 Typical High $66.07 | Facility | None | $28.84 | $66.07 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Security Health Setting Professional Modifier None Typical Low $21.38 Median $29.51 Typical High $35.48 | Professional | None | $21.38 | $29.51 | $35.48 |
United Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
United Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $28.84 | Professional | None | $20.89 | $20.89 | $28.84 |
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 $11.22 Median $11.22 Typical High $56.23 | Professional | 52 · Reduced service | $11.22 | $11.22 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $22.39 | Professional | 53 · Discontinued | $4.47 | $4.47 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $16.98 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $11.22 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $11.22 |
Where Wisconsin sits
The same service costs 1.9 times more in Alaska than in Maryland. 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· 7th of 51
$25.12
AK $39.81MD $20.89
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.