How much rates vary
Facilitymedian $45 · 10th to 90th $22 to $87Professionalmedian $29 · 10th to 90th $25 to $48
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 $29.51 Median $29.51 Typical High $56.23 | Facility | None | $29.51 | $29.51 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $213.80 | Professional | None | $28.84 | $29.51 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $43.65 | Professional | None | $28.84 | $28.84 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $64.57 Typical High $87.10 | Facility | None | $34.67 | $64.57 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $46.77 | Professional | None | $28.84 | $28.84 | $46.77 |
DeanCare Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $47.86 | Facility | None | $21.88 | $21.88 | $47.86 |
DeanCare Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $43.65 | Professional | None | $25.70 | $25.70 | $43.65 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $44.67 | Facility | None | $19.95 | $19.95 | $44.67 |
Medica Setting Professional Modifier None Typical Low $19.95 Median $21.88 Typical High $28.84 | Professional | None | $19.95 | $21.88 | $28.84 |
Network Health Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $45.71 | Facility | None | $38.02 | $38.02 | $45.71 |
Network Health Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $30.20 | Professional | None | $24.55 | $27.54 | $30.20 |
Prevea360 Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $47.86 | Facility | None | $21.88 | $21.88 | $47.86 |
Prevea360 Setting Professional Modifier None Typical Low $13.80 Median $43.65 Typical High $43.65 | Professional | None | $13.80 | $43.65 | $43.65 |
Quartz Setting Professional Modifier None Typical Low $27.54 Median $39.81 Typical High $89.13 | Professional | None | $27.54 | $39.81 | $89.13 |
Quartz Setting Facility Modifier None Typical Low $47.86 Median $87.10 Typical High $87.10 | Facility | None | $47.86 | $87.10 | $87.10 |
Quartz Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Security Health Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $63.10 | Professional | None | $38.90 | $47.86 | $63.10 |
United Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $33.11 | Professional | None | $24.55 | $27.54 | $33.11 |
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 $14.45 Median $14.79 Typical High $107.15 | Professional | 52 · Reduced service | $14.45 | $14.79 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.89 Typical High $42.66 | Professional | 53 · Discontinued | $5.75 | $5.89 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.47 Typical High $32.36 | Professional | 55 · Aftercare only | $4.37 | $4.47 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.95 Typical High $21.38 | Professional | 56 · Pre-op care only | $2.88 | $2.95 | $21.38 |
Where Wisconsin sits
The same service costs 2.8 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· 45th of 51
$28.84
WY $67.61AZ $24.55
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.