How much rates vary
Facilitymedian $135 · 10th to 90th $135 to $617Professionalmedian $251 · 10th to 90th $100 to $339
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 $239.88 Median $239.88 Typical High $537.03 | Facility | None | $239.88 | $239.88 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $363.08 | Professional | None | $239.88 | $257.04 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $512.86 Typical High $562.34 | Facility | None | $467.74 | $512.86 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $251.19 Typical High $389.05 | Professional | None | $70.79 | $251.19 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $537.03 Typical High $776.25 | Facility | None | $338.84 | $537.03 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $257.04 Typical High $281.84 | Professional | None | $109.65 | $257.04 | $281.84 |
DeanCare Setting Facility Modifier None Typical Low $63.10 Median $218.78 Typical High $239.88 | Facility | None | $63.10 | $218.78 | $239.88 |
DeanCare Setting Professional Modifier None Typical Low $33.88 Median $257.04 Typical High $323.59 | Professional | None | $33.88 | $257.04 | $323.59 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $223.87 Typical High $1,148.15 | Facility | None | $63.10 | $223.87 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $338.84 | Professional | None | $100.00 | $251.19 | $338.84 |
Network Health Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $257.04 | Facility | None | $251.19 | $257.04 | $257.04 |
Prevea360 Setting Facility Modifier None Typical Low $63.10 Median $218.78 Typical High $239.88 | Facility | None | $63.10 | $218.78 | $239.88 |
Prevea360 Setting Professional Modifier None Typical Low $33.88 Median $257.04 Typical High $323.59 | Professional | None | $33.88 | $257.04 | $323.59 |
Quartz Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $165.96 | Professional | None | $70.79 | $102.33 | $165.96 |
Quartz Setting Facility Modifier None Typical Low $338.84 Median $776.25 Typical High $776.25 | Facility | None | $338.84 | $776.25 | $776.25 |
Quartz Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Security Health Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Security Health Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $218.78 | Professional | None | $114.82 | $134.90 | $218.78 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $338.84 | Professional | None | $100.00 | $251.19 | $338.84 |
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 $120.23 Median $128.82 Typical High $181.97 | Professional | 52 · Reduced service | $120.23 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $47.86 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.02 Typical High $53.70 | Professional | 55 · Aftercare only | $36.31 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.99 | $25.70 | $36.31 |
Where Wisconsin sits
The same service costs 4.1 times more in Alaska than in Montana. 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· 34th of 51
$251
AK $407MT $100
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.