How much rates vary
Facilitymedian $316 · 10th to 90th $200 to $631Professionalmedian $214 · 10th to 90th $204 to $501
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 $213.80 Median $213.80 Typical High $467.74 | Facility | None | $213.80 | $213.80 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $660.69 | Professional | None | $204.17 | $213.80 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $436.52 | Facility | None | $257.04 | $257.04 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $309.03 | Professional | None | $204.17 | $204.17 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $338.84 Typical High $630.96 | Facility | None | $239.88 | $338.84 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $331.13 | Professional | None | $204.17 | $204.17 | $331.13 |
DeanCare Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $436.52 | Facility | None | $199.53 | $199.53 | $436.52 |
DeanCare Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $398.11 | Professional | None | $213.80 | $213.80 | $398.11 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $436.52 | Facility | None | $199.53 | $199.53 | $436.52 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $851.14 | Professional | None | $199.53 | $234.42 | $851.14 |
Network Health Setting Facility Modifier None Typical Low $190.55 Median $199.53 Typical High $199.53 | Facility | None | $190.55 | $199.53 | $199.53 |
Network Health Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | None | $204.17 | $229.09 | $229.09 |
Prevea360 Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $436.52 | Facility | None | $199.53 | $199.53 | $436.52 |
Prevea360 Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $398.11 | Professional | None | $295.12 | $398.11 | $398.11 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $501.19 | Professional | None | $204.17 | $323.59 | $501.19 |
Quartz Setting Facility Modifier None Typical Low $338.84 Median $630.96 Typical High $630.96 | Facility | None | $338.84 | $630.96 | $630.96 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Security Health Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $309.03 | Professional | None | $229.09 | $275.42 | $309.03 |
United Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $257.04 | Professional | None | $199.53 | $223.87 | $257.04 |
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 $104.71 Median $104.71 Typical High $354.81 | Professional | 52 · Reduced service | $104.71 | $104.71 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $42.66 Typical High $144.54 | Professional | 53 · Discontinued | $41.69 | $42.66 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $107.15 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.38 Typical High $70.79 | Professional | 56 · Pre-op care only | $20.89 | $21.38 | $70.79 |
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· 15th of 51
$214
AK $251NJ $204
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.