How much rates vary
Facilitymedian $52 · 10th to 90th $28 to $105Professionalmedian $34 · 10th to 90th $29 to $55
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 $35.48 Median $35.48 Typical High $66.07 | Facility | None | $35.48 | $35.48 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $302.00 | Professional | None | $33.88 | $35.48 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $61.66 | Facility | None | $42.66 | $42.66 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $51.29 | Professional | None | $33.88 | $33.88 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $64.57 Typical High $104.71 | Facility | None | $33.88 | $64.57 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
DeanCare Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $114.82 | Facility | None | $20.42 | $20.42 | $114.82 |
DeanCare Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $51.29 | Professional | None | $38.02 | $51.29 | $51.29 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $114.82 | Facility | None | $28.18 | $28.18 | $114.82 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $40.74 | Professional | None | $28.18 | $30.90 | $40.74 |
Network Health Setting Facility Modifier None Typical Low $46.77 Median $67.61 Typical High $67.61 | Facility | None | $46.77 | $67.61 | $67.61 |
Network Health Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $58.88 | Professional | None | $48.98 | $54.95 | $58.88 |
Prevea360 Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $114.82 | Facility | None | $20.42 | $20.42 | $114.82 |
Prevea360 Setting Professional Modifier None Typical Low $10.72 Median $40.74 Typical High $40.74 | Professional | None | $10.72 | $40.74 | $40.74 |
Quartz Setting Professional Modifier None Typical Low $26.92 Median $39.81 Typical High $95.50 | Professional | None | $26.92 | $39.81 | $95.50 |
Quartz Setting Facility Modifier None Typical Low $56.23 Median $104.71 Typical High $104.71 | Facility | None | $56.23 | $104.71 | $104.71 |
Quartz Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Security Health Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $154.88 | Professional | None | $45.71 | $56.23 | $154.88 |
The Alliance Setting Professional Modifier None Typical Low $26.30 Median $50.12 Typical High $64.57 | Professional | None | $26.30 | $50.12 | $64.57 |
United Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $28.18 Median $31.62 Typical High $38.02 | Professional | None | $28.18 | $31.62 | $38.02 |
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 $17.38 Median $17.38 Typical High $165.96 | Professional | 52 · Reduced service | $17.38 | $17.38 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $7.08 Typical High $66.07 | Professional | 53 · Discontinued | $6.92 | $7.08 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.25 Typical High $48.98 | Professional | 55 · Aftercare only | $5.13 | $5.25 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.55 Typical High $33.11 | Professional | 56 · Pre-op care only | $3.47 | $3.55 | $33.11 |
Where Wisconsin sits
The same service costs 5.4 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· 18th of 51
$33.88
WY $162AZ $30.20
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.