How much rates vary
Facilitymedian $54 · 10th to 90th $30 to $100Professionalmedian $34 · 10th to 90th $31 to $71
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 $33.88 Median $33.88 Typical High $72.44 | Facility | None | $33.88 | $33.88 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.88 Typical High $75.86 | Professional | None | $33.11 | $33.88 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $67.61 | Facility | None | $40.74 | $40.74 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $48.98 | Professional | None | $33.11 | $33.11 | $48.98 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $45.71 | Professional | None | $30.20 | $30.20 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $75.86 Typical High $100.00 | Facility | None | $51.29 | $75.86 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $50.12 | Professional | None | $33.11 | $33.11 | $50.12 |
DeanCare Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $66.07 | Facility | None | $30.20 | $30.20 | $66.07 |
DeanCare Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $60.26 | Professional | None | $31.62 | $31.62 | $60.26 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $66.07 | Facility | None | $30.20 | $30.20 | $66.07 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $35.48 Typical High $125.89 | Professional | None | $30.20 | $35.48 | $125.89 |
Network Health Setting Facility Modifier None Typical Low $27.54 Median $28.84 Typical High $28.84 | Facility | None | $27.54 | $28.84 | $28.84 |
Network Health Setting Professional Modifier None Typical Low $30.20 Median $33.88 Typical High $33.88 | Professional | None | $30.20 | $33.88 | $33.88 |
Prevea360 Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $66.07 | Facility | None | $30.20 | $30.20 | $66.07 |
Prevea360 Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $60.26 | Professional | None | $44.67 | $60.26 | $60.26 |
Quartz Setting Professional Modifier None Typical Low $33.11 Median $50.12 Typical High $75.86 | Professional | None | $33.11 | $50.12 | $75.86 |
Quartz Setting Facility Modifier None Typical Low $53.70 Median $100.00 Typical High $100.00 | Facility | None | $53.70 | $100.00 | $100.00 |
Quartz Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Security Health Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $54.95 | Professional | None | $44.67 | $44.67 | $54.95 |
The Alliance Setting Professional Modifier None Typical Low $38.90 Median $63.10 Typical High $75.86 | Professional | None | $38.90 | $63.10 | $75.86 |
United Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $39.81 | Professional | None | $30.90 | $34.67 | $39.81 |
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 $16.60 Median $16.98 Typical High $37.15 | Professional | 52 · Reduced service | $16.60 | $16.98 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.76 Typical High $15.14 | Professional | 53 · Discontinued | $6.61 | $6.76 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.13 Typical High $11.22 | Professional | 55 · Aftercare only | $4.90 | $5.13 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.39 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.31 | $3.39 | $7.59 |
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· 9th of 51
$33.88
AK $41.69AZ $33.11
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.