How much rates vary
Facilitymedian $27 · 10th to 90th $17 to $52Professionalmedian $18 · 10th to 90th $17 to $41
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 $17.78 Median $17.78 Typical High $38.90 | Facility | None | $17.78 | $17.78 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.78 Typical High $42.66 | Professional | None | $17.38 | $17.78 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $36.31 | Facility | None | $21.38 | $21.38 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $25.70 | Professional | None | $17.38 | $17.38 | $25.70 |
CareSource Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $26.30 | Professional | None | $16.98 | $16.98 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $41.69 Typical High $52.48 | Facility | None | $25.12 | $41.69 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $28.18 | Professional | None | $17.38 | $17.38 | $28.18 |
DeanCare Setting Facility Modifier None Typical Low $11.22 Median $16.98 Typical High $38.02 | Facility | None | $11.22 | $16.98 | $38.02 |
DeanCare Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $33.88 | Professional | None | $17.78 | $17.78 | $33.88 |
Medica Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $37.15 | Facility | None | $16.98 | $16.98 | $37.15 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $4,897.79 | Professional | None | $16.98 | $19.95 | $4,897.79 |
Network Health Setting Facility Modifier None Typical Low $15.14 Median $16.22 Typical High $16.22 | Facility | None | $15.14 | $16.22 | $16.22 |
Network Health Setting Professional Modifier None Typical Low $16.98 Median $19.05 Typical High $19.05 | Professional | None | $16.98 | $19.05 | $19.05 |
Prevea360 Setting Facility Modifier None Typical Low $11.22 Median $16.98 Typical High $38.02 | Facility | None | $11.22 | $16.98 | $38.02 |
Prevea360 Setting Professional Modifier None Typical Low $25.70 Median $33.88 Typical High $33.88 | Professional | None | $25.70 | $33.88 | $33.88 |
Quartz Setting Professional Modifier None Typical Low $17.38 Median $26.92 Typical High $43.65 | Professional | None | $17.38 | $26.92 | $43.65 |
Quartz Setting Facility Modifier None Typical Low $28.18 Median $52.48 Typical High $52.48 | Facility | None | $28.18 | $52.48 | $52.48 |
Quartz Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Security Health Setting Professional Modifier None Typical Low $12.88 Median $23.44 Typical High $25.70 | Professional | None | $12.88 | $23.44 | $25.70 |
The Alliance Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $42.66 | Professional | None | $22.91 | $35.48 | $42.66 |
United Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
United Setting Professional Modifier None Typical Low $16.98 Median $18.62 Typical High $21.38 | Professional | None | $16.98 | $18.62 | $21.38 |
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 $8.51 Median $8.91 Typical High $21.38 | Professional | 52 · Reduced service | $8.51 | $8.91 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.55 Typical High $8.51 | Professional | 53 · Discontinued | $3.47 | $3.55 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.63 Typical High $6.46 | Professional | 55 · Aftercare only | $2.57 | $2.63 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.78 Typical High $4.27 | Professional | 56 · Pre-op care only | $1.74 | $1.78 | $4.27 |
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· 12th of 51
$17.78
AK $21.88NC $16.98
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.