How much rates vary
Facilitymedian $437 · 10th to 90th $257 to $851Professionalmedian $288 · 10th to 90th $269 to $437
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 $288.40 Median $288.40 Typical High $616.60 | Facility | None | $288.40 | $288.40 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $741.31 | Professional | None | $281.84 | $288.40 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $575.44 | Facility | None | $346.74 | $346.74 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $416.87 | Professional | None | $281.84 | $281.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $660.69 Typical High $851.14 | Facility | None | $389.05 | $660.69 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $416.87 | Professional | None | $281.84 | $281.84 | $416.87 |
DeanCare Setting Facility Modifier None Typical Low $144.54 Median $257.04 Typical High $575.44 | Facility | None | $144.54 | $257.04 | $575.44 |
DeanCare Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $512.86 | Professional | None | $275.42 | $275.42 | $512.86 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $257.04 Typical High $575.44 | Facility | None | $144.54 | $257.04 | $575.44 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $346.74 | Professional | None | $257.04 | $281.84 | $346.74 |
Network Health Setting Facility Modifier None Typical Low $204.17 Median $245.47 Typical High $245.47 | Facility | None | $204.17 | $245.47 | $245.47 |
Network Health Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | None | $263.03 | $295.12 | $295.12 |
Prevea360 Setting Facility Modifier None Typical Low $144.54 Median $257.04 Typical High $575.44 | Facility | None | $144.54 | $257.04 | $575.44 |
Prevea360 Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $512.86 | Professional | None | $389.05 | $512.86 | $512.86 |
Quartz Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $660.69 | Professional | None | $281.84 | $426.58 | $660.69 |
Quartz Setting Facility Modifier None Typical Low $457.09 Median $851.14 Typical High $851.14 | Facility | None | $457.09 | $851.14 | $851.14 |
Quartz Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Security Health Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $389.05 | Professional | None | $177.83 | $281.84 | $389.05 |
The Alliance Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $338.84 | Professional | None | $269.15 | $295.12 | $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 $138.04 Median $144.54 Typical High $371.54 | Professional | 52 · Reduced service | $138.04 | $144.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $57.54 Typical High $151.36 | Professional | 53 · Discontinued | $56.23 | $57.54 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $112.20 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $74.13 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $74.13 |
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· 9th of 51
$288
AK $339NC $275
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.