How much rates vary
Facilitymedian $110 · 10th to 90th $72 to $214Professionalmedian $76 · 10th to 90th $71 to $145
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 $72.44 Median $72.44 Typical High $169.82 | Facility | None | $72.44 | $72.44 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $72.44 Typical High $302.00 | Professional | None | $70.79 | $72.44 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $158.49 | Facility | None | $87.10 | $87.10 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $104.71 | Professional | None | $70.79 | $70.79 | $104.71 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $114.82 | Professional | None | $75.86 | $75.86 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $114.82 Typical High $213.80 | Facility | None | $91.20 | $114.82 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $131.83 | Professional | None | $70.79 | $70.79 | $131.83 |
DeanCare Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $97.72 | Facility | None | $70.79 | $75.86 | $97.72 |
DeanCare Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $151.36 | Professional | None | $85.11 | $85.11 | $151.36 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $97.72 | Facility | None | $70.79 | $75.86 | $97.72 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $112.20 | Professional | None | $75.86 | $83.18 | $112.20 |
Network Health Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $87.10 | Facility | None | $85.11 | $85.11 | $87.10 |
Network Health Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $97.72 | Professional | None | $81.28 | $91.20 | $97.72 |
Prevea360 Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $97.72 | Facility | None | $70.79 | $75.86 | $97.72 |
Prevea360 Setting Professional Modifier None Typical Low $41.69 Median $151.36 Typical High $151.36 | Professional | None | $41.69 | $151.36 | $151.36 |
Quartz Setting Professional Modifier None Typical Low $70.79 Median $131.83 Typical High $204.17 | Professional | None | $70.79 | $131.83 | $204.17 |
Quartz Setting Facility Modifier None Typical Low $114.82 Median $213.80 Typical High $213.80 | Facility | None | $114.82 | $213.80 | $213.80 |
Quartz Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Security Health Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $144.54 | Professional | None | $95.50 | $114.82 | $144.54 |
The Alliance Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $223.87 | Professional | None | $102.33 | $186.21 | $223.87 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $97.72 | Professional | None | $74.13 | $81.28 | $97.72 |
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 $35.48 Median $36.31 Typical High $151.36 | Professional | 52 · Reduced service | $35.48 | $36.31 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.45 Typical High $60.26 | Professional | 53 · Discontinued | $14.13 | $14.45 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.96 Typical High $45.71 | Professional | 55 · Aftercare only | $10.72 | $10.96 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.24 Typical High $30.20 | Professional | 56 · Pre-op care only | $7.08 | $7.24 | $30.20 |
Where Wisconsin sits
The same service costs 1.5 times more in Wyoming than in Florida. 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· 14th of 51
$75.86
WY $107FL $70.79
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.