How much rates vary
Facilitymedian $646 · 10th to 90th $389 to $1,202Professionalmedian $447 · 10th to 90th $380 to $776
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 $407.38 Median $407.38 Typical High $891.25 | Facility | None | $407.38 | $407.38 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $2,454.71 | Professional | None | $407.38 | $407.38 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $831.76 | Facility | None | $489.78 | $489.78 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $588.84 | Professional | None | $389.05 | $446.68 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $870.96 Typical High $1,202.26 | Facility | None | $524.81 | $870.96 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $707.95 | Professional | None | $389.05 | $467.74 | $707.95 |
DeanCare Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $851.14 | Facility | None | $389.05 | $389.05 | $851.14 |
DeanCare Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $776.25 | Professional | None | $575.44 | $776.25 | $776.25 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $831.76 | Facility | None | $380.19 | $380.19 | $831.76 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $575.44 | Professional | None | $380.19 | $426.58 | $575.44 |
Network Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Prevea360 Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $851.14 | Facility | None | $389.05 | $389.05 | $851.14 |
Prevea360 Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $776.25 | Professional | None | $575.44 | $776.25 | $776.25 |
Quartz Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $977.24 | Professional | None | $389.05 | $616.60 | $977.24 |
Quartz Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $1,202.26 | Facility | None | $524.81 | $1,202.26 | $1,202.26 |
Quartz Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $645.65 | Professional | None | $524.81 | $524.81 | $645.65 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $562.34 | Professional | None | $380.19 | $426.58 | $562.34 |
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 $204.17 Median $204.17 Typical High $1,230.27 | Professional | 52 · Reduced service | $204.17 | $204.17 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $489.78 | Professional | 53 · Discontinued | $81.28 | $81.28 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $371.54 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $245.47 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $245.47 |
Where Wisconsin sits
The same service costs 1.9 times more in Texas than in Illinois. 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· 8th of 51
$468
TX $741IL $389
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.