How much rates vary
Facilitymedian $28 · 10th to 90th $18 to $55Professionalmedian $20 · 10th to 90th $18 to $36
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 $18.62 Median $18.62 Typical High $41.69 | Facility | None | $18.62 | $18.62 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $63.10 | Professional | None | $18.62 | $18.62 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $38.90 | Facility | None | $22.91 | $22.91 | $38.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $26.92 | Professional | None | $18.20 | $19.95 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $43.65 Typical High $54.95 | Facility | None | $26.30 | $43.65 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $22.91 Typical High $32.36 | Professional | None | $18.20 | $22.91 | $32.36 |
DeanCare Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $213.80 | Facility | None | $17.78 | $17.78 | $213.80 |
DeanCare Setting Professional Modifier None Typical Low $26.30 Median $35.48 Typical High $125.89 | Professional | None | $26.30 | $35.48 | $125.89 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $213.80 | Facility | None | $17.38 | $17.38 | $213.80 |
Medica Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $30.20 | Professional | None | $17.38 | $17.38 | $30.20 |
Network Health Setting Facility Modifier None Typical Low $17.78 Median $18.20 Typical High $18.20 | Facility | None | $17.78 | $18.20 | $18.20 |
Prevea360 Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $213.80 | Facility | None | $17.78 | $17.78 | $213.80 |
Prevea360 Setting Professional Modifier None Typical Low $26.30 Median $35.48 Typical High $125.89 | Professional | None | $26.30 | $35.48 | $125.89 |
Quartz Setting Professional Modifier None Typical Low $18.20 Median $28.84 Typical High $44.67 | Professional | None | $18.20 | $28.84 | $44.67 |
Quartz Setting Facility Modifier None Typical Low $23.99 Median $54.95 Typical High $54.95 | Facility | None | $23.99 | $54.95 | $54.95 |
Quartz Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Security Health Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $199.53 | Professional | None | $24.55 | $24.55 | $199.53 |
United Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $24.55 | Professional | None | $18.20 | $18.20 | $24.55 |
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 $9.33 Median $9.33 Typical High $31.62 | Professional | 52 · Reduced service | $9.33 | $9.33 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $12.59 | Professional | 53 · Discontinued | $3.72 | $3.72 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $9.33 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $6.31 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $6.31 |
Where Wisconsin sits
The same service costs 28.8 times more in Alabama than in Washington, DC. 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· 9th of 51
$21.38
AL $525DC $18.20
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.