How much rates vary
Facilitymedian $186 · 10th to 90th $123 to $407Professionalmedian $174 · 10th to 90th $91 to $282
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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $489.78 | Professional | None | $134.90 | $134.90 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $213.80 Typical High $309.03 | Facility | None | $186.21 | $213.80 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $251.19 | Professional | None | $112.20 | $186.21 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $380.19 Typical High $794.33 | Facility | None | $125.89 | $380.19 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $354.81 | Professional | None | $91.20 | $134.90 | $354.81 |
DeanCare Setting Facility Modifier None Typical Low $58.88 Median $181.97 Typical High $213.80 | Facility | None | $58.88 | $181.97 | $213.80 |
DeanCare Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $263.03 | Professional | None | $199.53 | $251.19 | $263.03 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $181.97 Typical High $1,000.00 | Facility | None | $93.33 | $181.97 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $239.88 | Professional | None | $85.11 | $117.49 | $239.88 |
Network Health Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Network Health Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $323.59 | Professional | None | $131.83 | $173.78 | $323.59 |
Prevea360 Setting Facility Modifier None Typical Low $58.88 Median $181.97 Typical High $213.80 | Facility | None | $58.88 | $181.97 | $213.80 |
Prevea360 Setting Professional Modifier None Typical Low $104.71 Median $181.97 Typical High $199.53 | Professional | None | $104.71 | $181.97 | $199.53 |
Quartz Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $467.74 | Professional | None | $186.21 | $281.84 | $467.74 |
Quartz Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Quartz Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $302.00 | Facility | None | $87.10 | $100.00 | $302.00 |
United Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $162.18 | Professional | None | $72.44 | $95.50 | $162.18 |
6 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 $67.61 Median $67.61 Typical High $245.47 | Professional | 52 · Reduced service | $67.61 | $67.61 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $97.72 | Professional | 53 · Discontinued | $26.92 | $26.92 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $74.13 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $48.98 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $48.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $31.62 | Professional | RR · Rental | $11.22 | $11.22 | $31.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | UE · Used equipment | $83.18 | $83.18 | $91.20 |
Where Wisconsin sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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
$174
HI $219DE $91.20
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.