How much rates vary
Facilitymedian $38 · 10th to 90th $21 to $76Professionalmedian $25 · 10th to 90th $21 to $54
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 $25.70 Median $25.70 Typical High $38.02 | Facility | None | $25.70 | $25.70 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.70 Typical High $186.21 | Professional | None | $25.12 | $25.70 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $37.15 | Professional | None | $25.12 | $25.12 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $56.23 Typical High $75.86 | Facility | None | $32.36 | $56.23 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $41.69 | Professional | None | $25.12 | $25.12 | $41.69 |
DeanCare Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $29.51 | Facility | None | $21.38 | $21.38 | $29.51 |
DeanCare Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $42.66 | Professional | None | $22.91 | $22.91 | $42.66 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $56.23 | Facility | None | $20.89 | $20.89 | $56.23 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $22.91 Typical High $77.62 | Professional | None | $20.89 | $22.91 | $77.62 |
Network Health Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $44.67 | Facility | None | $22.39 | $22.39 | $44.67 |
Network Health Setting Professional Modifier None Typical Low $21.88 Median $24.55 Typical High $25.12 | Professional | None | $21.88 | $24.55 | $25.12 |
Prevea360 Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $29.51 | Facility | None | $21.38 | $21.38 | $29.51 |
Prevea360 Setting Professional Modifier None Typical Low $25.12 Median $42.66 Typical High $42.66 | Professional | None | $25.12 | $42.66 | $42.66 |
Quartz Setting Professional Modifier None Typical Low $25.12 Median $38.90 Typical High $54.95 | Professional | None | $25.12 | $38.90 | $54.95 |
Quartz Setting Facility Modifier None Typical Low $40.74 Median $75.86 Typical High $75.86 | Facility | None | $40.74 | $75.86 | $75.86 |
Quartz Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Security Health Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $41.69 | Professional | None | $30.90 | $34.67 | $41.69 |
The Alliance Setting Professional Modifier None Typical Low $28.18 Median $50.12 Typical High $53.70 | Professional | None | $28.18 | $50.12 | $53.70 |
United Setting Professional Modifier None Typical Low $16.60 Median $18.20 Typical High $74.13 | Professional | None | $16.60 | $18.20 | $74.13 |
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 $12.59 Median $12.88 Typical High $93.33 | Professional | 52 · Reduced service | $12.59 | $12.88 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.13 Typical High $38.02 | Professional | 53 · Discontinued | $5.01 | $5.13 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $28.18 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.57 Typical High $18.62 | Professional | 56 · Pre-op care only | $2.51 | $2.57 | $18.62 |
Where Wisconsin sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 39th of 51
$25.12
WY $39.81AZ $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.