How much rates vary
Facilitymedian $93 · 10th to 90th $55 to $182Professionalmedian $62 · 10th to 90th $56 to $91
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 $61.66 Median $61.66 Typical High $128.82 | Facility | None | $61.66 | $61.66 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $123.03 | Professional | None | $60.26 | $61.66 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $120.23 | Facility | None | $75.86 | $75.86 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $91.20 | Professional | None | $60.26 | $60.26 | $91.20 |
CareSource Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $85.11 | Professional | None | $56.23 | $56.23 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $134.90 Typical High $181.97 | Facility | None | $83.18 | $134.90 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | None | $60.26 | $60.26 | $87.10 |
DeanCare Setting Facility Modifier None Typical Low $33.11 Median $56.23 Typical High $123.03 | Facility | None | $33.11 | $56.23 | $123.03 |
DeanCare Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $112.20 | Professional | None | $57.54 | $57.54 | $112.20 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $54.95 Typical High $87.10 | Facility | None | $33.11 | $54.95 | $87.10 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $74.13 | Professional | None | $54.95 | $60.26 | $74.13 |
Network Health Setting Facility Modifier None Typical Low $47.86 Median $50.12 Typical High $50.12 | Facility | None | $47.86 | $50.12 | $50.12 |
Network Health Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | None | $54.95 | $61.66 | $61.66 |
Prevea360 Setting Facility Modifier None Typical Low $33.11 Median $56.23 Typical High $123.03 | Facility | None | $33.11 | $56.23 | $123.03 |
Prevea360 Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $112.20 | Professional | None | $83.18 | $112.20 | $112.20 |
Quartz Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $141.25 | Professional | None | $60.26 | $89.13 | $141.25 |
Quartz Setting Facility Modifier None Typical Low $100.00 Median $181.97 Typical High $181.97 | Facility | None | $100.00 | $181.97 | $181.97 |
Quartz Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Security Health Setting Professional Modifier None Typical Low $38.90 Median $81.28 Typical High $83.18 | Professional | None | $38.90 | $81.28 | $83.18 |
The Alliance Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | None | $81.28 | $81.28 | $95.50 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $72.44 | Professional | None | $56.23 | $61.66 | $72.44 |
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 $30.20 Median $30.90 Typical High $61.66 | Professional | 52 · Reduced service | $30.20 | $30.90 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $24.55 | Professional | 53 · Discontinued | $12.30 | $12.30 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $18.62 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $12.30 |
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
$61.66
AK $74.13OK $58.88
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.