How much rates vary
Facilitymedian $132 · 10th to 90th $81 to $263Professionalmedian $89 · 10th to 90th $81 to $195
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 $89.13 Median $89.13 Typical High $190.55 | Facility | None | $89.13 | $89.13 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $281.84 | Professional | None | $85.11 | $89.13 | $281.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $44.67 Typical High $141.25 | Professional | 52 · Reduced service | $42.66 | $44.67 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.78 Typical High $56.23 | Professional | 53 · Discontinued | $16.98 | $17.78 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $41.69 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $177.83 | Facility | None | $107.15 | $107.15 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $128.82 | Professional | None | $85.11 | $85.11 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $199.53 Typical High $263.03 | Facility | None | $123.03 | $199.53 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $134.90 | Professional | None | $85.11 | $85.11 | $134.90 |
DeanCare Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $181.97 | Facility | None | $81.28 | $81.28 | $181.97 |
DeanCare Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $165.96 | Professional | None | $85.11 | $85.11 | $165.96 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $181.97 | Facility | None | $81.28 | $81.28 | $181.97 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $338.84 | Professional | None | $81.28 | $97.72 | $338.84 |
Network Health Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Network Health Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $91.20 | Professional | None | $81.28 | $91.20 | $91.20 |
Prevea360 Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $181.97 | Facility | None | $81.28 | $81.28 | $181.97 |
Prevea360 Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $165.96 | Professional | None | $123.03 | $165.96 | $165.96 |
Quartz Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $208.93 | Professional | None | $85.11 | $131.83 | $208.93 |
Quartz Setting Facility Modifier None Typical Low $141.25 Median $263.03 Typical High $263.03 | Facility | None | $141.25 | $263.03 | $263.03 |
Quartz Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Security Health Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $141.25 | Professional | None | $114.82 | $117.49 | $141.25 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $104.71 | Professional | None | $81.28 | $91.20 | $104.71 |
1 more rate 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 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $8.91 |
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· 12th of 51
$89.13
AK $105OK $85.11
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.