How much rates vary
Facilitymedian $162 · 10th to 90th $107 to $324Professionalmedian $107 · 10th to 90th $105 to $174
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 $107.15 Median $107.15 Typical High $275.42 | Facility | None | $107.15 | $107.15 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $109.65 | Professional | None | $104.71 | $107.15 | $109.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $257.04 | Facility | None | $131.83 | $131.83 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $158.49 | Professional | None | $104.71 | $104.71 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $323.59 | Facility | None | $128.82 | $213.80 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $154.88 | Professional | None | $104.71 | $104.71 | $154.88 |
DeanCare Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $741.31 | Facility | None | $95.50 | $95.50 | $741.31 |
DeanCare Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $190.55 | Professional | None | $147.91 | $147.91 | $190.55 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $741.31 | Facility | None | $107.15 | $107.15 | $741.31 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $158.49 | Professional | None | $107.15 | $117.49 | $158.49 |
Network Health Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $234.42 | Facility | None | $158.49 | $158.49 | $234.42 |
Network Health Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $162.18 | Professional | None | $141.25 | $158.49 | $162.18 |
Prevea360 Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $741.31 | Facility | None | $95.50 | $95.50 | $741.31 |
Prevea360 Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $190.55 | Professional | None | $144.54 | $190.55 | $190.55 |
Quartz Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $245.47 | Professional | None | $104.71 | $173.78 | $245.47 |
Quartz Setting Facility Modifier None Typical Low $173.78 Median $323.59 Typical High $323.59 | Facility | None | $173.78 | $323.59 | $323.59 |
Quartz Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Security Health Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $1,000.00 | Professional | None | $141.25 | $173.78 | $1,000.00 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $162.18 | Professional | None | $120.23 | $131.83 | $162.18 |
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 $52.48 Median $53.70 Typical High $891.25 | Professional | 52 · Reduced service | $52.48 | $53.70 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $389.05 | Professional | 53 · Discontinued | $21.38 | $21.38 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.22 Typical High $295.12 | Professional | 55 · Aftercare only | $15.85 | $16.22 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $194.98 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $194.98 |
Where Wisconsin sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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
$112
WY $204VT $105
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.