How much rates vary
Facilitymedian $1,072 · 10th to 90th $692 to $2,089Professionalmedian $708 · 10th to 90th $692 to $1,380
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 $707.95 Median $707.95 Typical High $1,584.89 | Facility | None | $707.95 | $707.95 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $1,348.96 | Professional | None | $691.83 | $707.95 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,479.11 | Facility | None | $851.14 | $851.14 | $1,479.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,023.29 | Professional | None | $691.83 | $691.83 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $2,089.30 | Facility | None | $1,071.52 | $1,698.24 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,023.29 | Professional | None | $691.83 | $691.83 | $1,023.29 |
DeanCare Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $1,513.56 | Facility | None | $691.83 | $691.83 | $1,513.56 |
DeanCare Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,380.38 | Professional | None | $707.95 | $707.95 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $1,513.56 | Facility | None | $691.83 | $691.83 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $2,818.38 | Professional | None | $691.83 | $812.83 | $2,818.38 |
Network Health Setting Facility Modifier None Typical Low $588.84 Median $645.65 Typical High $645.65 | Facility | None | $588.84 | $645.65 | $645.65 |
Network Health Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $812.83 | Professional | None | $446.68 | $676.08 | $812.83 |
Prevea360 Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $1,513.56 | Facility | None | $691.83 | $691.83 | $1,513.56 |
Prevea360 Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,380.38 | $1,380.38 |
Quartz Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,737.80 | Professional | None | $691.83 | $1,096.48 | $1,737.80 |
Quartz Setting Facility Modifier None Typical Low $1,122.02 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,122.02 | $2,089.30 | $2,089.30 |
Quartz Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Security Health Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $1,148.15 | Professional | None | $933.25 | $954.99 | $1,148.15 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
United Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $870.96 | Professional | None | $691.83 | $758.58 | $870.96 |
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 $346.74 Median $354.81 Typical High $676.08 | Professional | 52 · Reduced service | $346.74 | $354.81 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $141.25 Typical High $269.15 | Professional | 53 · Discontinued | $138.04 | $141.25 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $199.53 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $70.79 Typical High $134.90 | Professional | 56 · Pre-op care only | $69.18 | $70.79 | $134.90 |
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
$708
AK $832IN $692
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.