How much rates vary
Facilitymedian $257 · 10th to 90th $166 to $490Professionalmedian $170 · 10th to 90th $162 to $347
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 $165.96 Median $165.96 Typical High $407.38 | Facility | None | $165.96 | $165.96 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $776.25 | Professional | None | $162.18 | $165.96 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $380.19 | Facility | None | $199.53 | $199.53 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $239.88 | Professional | None | $162.18 | $162.18 | $239.88 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $269.15 | Professional | None | $177.83 | $177.83 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $416.87 Typical High $489.78 | Facility | None | $251.19 | $416.87 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $309.03 | Professional | None | $162.18 | $162.18 | $309.03 |
DeanCare Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $316.23 | Facility | None | $177.83 | $177.83 | $316.23 |
DeanCare Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $354.81 | Professional | None | $199.53 | $199.53 | $354.81 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $537.03 | Facility | None | $154.88 | $154.88 | $537.03 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $229.09 | Professional | None | $154.88 | $173.78 | $229.09 |
Network Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Facility | None | $190.55 | $190.55 | $199.53 |
Network Health Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $229.09 | Professional | None | $190.55 | $213.80 | $229.09 |
Prevea360 Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $316.23 | Facility | None | $177.83 | $177.83 | $316.23 |
Prevea360 Setting Professional Modifier None Typical Low $169.82 Median $354.81 Typical High $354.81 | Professional | None | $169.82 | $354.81 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $446.68 | Professional | None | $162.18 | $302.00 | $446.68 |
Quartz Setting Facility Modifier None Typical Low $263.03 Median $489.78 Typical High $489.78 | Facility | None | $263.03 | $489.78 | $489.78 |
Quartz Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Security Health Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $316.23 | Professional | None | $218.78 | $263.03 | $316.23 |
The Alliance Setting Professional Modifier None Typical Low $229.09 Median $436.52 Typical High $501.19 | Professional | None | $229.09 | $436.52 | $501.19 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $234.42 | Professional | None | $177.83 | $194.98 | $234.42 |
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 $81.28 Median $83.18 Typical High $426.58 | Professional | 52 · Reduced service | $81.28 | $83.18 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.11 Typical High $169.82 | Professional | 53 · Discontinued | $32.36 | $33.11 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $125.89 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.60 Typical High $85.11 | Professional | 56 · Pre-op care only | $16.22 | $16.60 | $85.11 |
Where Wisconsin sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 25th of 51
$174
WY $302NV $162
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.