How much rates vary
Facilitymedian $87 · 10th to 90th $52 to $174Professionalmedian $58 · 10th to 90th $54 to $132
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 $57.54 Median $57.54 Typical High $123.03 | Facility | None | $57.54 | $57.54 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $181.97 | Professional | None | $57.54 | $57.54 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $114.82 | Facility | None | $70.79 | $70.79 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $85.11 | Professional | None | $56.23 | $56.23 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $131.83 Typical High $173.78 | Facility | None | $87.10 | $131.83 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $79.43 | Professional | None | $56.23 | $56.23 | $79.43 |
DeanCare Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $114.82 | Facility | None | $52.48 | $52.48 | $114.82 |
DeanCare Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $104.71 | Professional | None | $54.95 | $54.95 | $104.71 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $112.20 | Facility | None | $50.12 | $50.12 | $112.20 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $218.78 | Professional | None | $50.12 | $60.26 | $218.78 |
Network Health Setting Facility Modifier None Typical Low $47.86 Median $50.12 Typical High $50.12 | Facility | None | $47.86 | $50.12 | $50.12 |
Network Health Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $58.88 | Professional | None | $51.29 | $58.88 | $58.88 |
Prevea360 Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $114.82 | Facility | None | $52.48 | $52.48 | $114.82 |
Prevea360 Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $104.71 | Professional | None | $79.43 | $104.71 | $104.71 |
Quartz Setting Professional Modifier None Typical Low $56.23 Median $85.11 Typical High $134.90 | Professional | None | $56.23 | $85.11 | $134.90 |
Quartz Setting Facility Modifier None Typical Low $93.33 Median $173.78 Typical High $173.78 | Facility | None | $93.33 | $173.78 | $173.78 |
Quartz Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Security Health Setting Professional Modifier None Typical Low $75.86 Median $77.62 Typical High $93.33 | Professional | None | $75.86 | $77.62 | $93.33 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $69.18 | Professional | None | $53.70 | $58.88 | $69.18 |
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 $28.18 Median $28.84 Typical High $89.13 | Professional | 52 · Reduced service | $28.18 | $28.84 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $36.31 | Professional | 53 · Discontinued | $11.22 | $11.75 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.71 Typical High $26.92 | Professional | 55 · Aftercare only | $8.51 | $8.71 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $18.20 | Professional | 56 · Pre-op care only | $5.62 | $5.75 | $18.20 |
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
$57.54
AK $69.18AL $56.23
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.