How much rates vary
Facilitymedian $380 · 10th to 90th $219 to $692Professionalmedian $234 · 10th to 90th $224 to $575
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 $234.42 Median $234.42 Typical High $512.86 | Facility | None | $234.42 | $234.42 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $891.25 | Professional | None | $229.09 | $234.42 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $478.63 | Facility | None | $281.84 | $281.84 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $338.84 | Professional | None | $229.09 | $229.09 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $501.19 Typical High $691.83 | Facility | None | $354.81 | $501.19 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $363.08 | Professional | None | $229.09 | $229.09 | $363.08 |
DeanCare Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $478.63 | Facility | None | $218.78 | $218.78 | $478.63 |
DeanCare Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $436.52 | Professional | None | $234.42 | $234.42 | $436.52 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $478.63 | Facility | None | $218.78 | $218.78 | $478.63 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $954.99 | Professional | None | $218.78 | $257.04 | $954.99 |
Network Health Setting Facility Modifier None Typical Low $208.93 Median $223.87 Typical High $223.87 | Facility | None | $208.93 | $223.87 | $223.87 |
Network Health Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | None | $223.87 | $251.19 | $251.19 |
Prevea360 Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $478.63 | Facility | None | $218.78 | $218.78 | $478.63 |
Prevea360 Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $436.52 | Professional | None | $323.59 | $436.52 | $436.52 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $549.54 | Professional | None | $229.09 | $354.81 | $549.54 |
Quartz Setting Facility Modifier None Typical Low $380.19 Median $691.83 Typical High $691.83 | Facility | None | $380.19 | $691.83 | $691.83 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Security Health Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $380.19 | Professional | None | $309.03 | $316.23 | $380.19 |
United Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $281.84 | Professional | None | $223.87 | $245.47 | $281.84 |
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 $114.82 Median $117.49 Typical High $446.68 | Professional | 52 · Reduced service | $114.82 | $117.49 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $177.83 | Professional | 53 · Discontinued | $45.71 | $46.77 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $35.48 Typical High $134.90 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.44 Typical High $89.13 | Professional | 56 · Pre-op care only | $22.91 | $23.44 | $89.13 |
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· 14th of 51
$234
AK $282TN $229
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.