How much rates vary
Facilitymedian $132 · 10th to 90th $78 to $282Professionalmedian $123 · 10th to 90th $56 to $204
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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $281.84 | Professional | None | $87.10 | $93.33 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $151.36 Typical High $218.78 | Facility | None | $131.83 | $151.36 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $131.83 Typical High $165.96 | Professional | None | $75.86 | $131.83 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $269.15 Typical High $323.59 | Facility | None | $77.62 | $269.15 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $251.19 | Professional | None | $56.23 | $100.00 | $251.19 |
DeanCare Setting Facility Modifier None Typical Low $38.90 Median $128.82 Typical High $147.91 | Facility | None | $38.90 | $128.82 | $147.91 |
DeanCare Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $213.80 | Professional | None | $141.25 | $204.17 | $213.80 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $128.82 Typical High $645.65 | Facility | None | $64.57 | $128.82 | $645.65 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $177.83 | Professional | None | $57.54 | $85.11 | $177.83 |
Network Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Network Health Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $223.87 | Professional | None | $93.33 | $120.23 | $223.87 |
Prevea360 Setting Facility Modifier None Typical Low $38.90 Median $128.82 Typical High $147.91 | Facility | None | $38.90 | $128.82 | $147.91 |
Prevea360 Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $162.18 | Professional | None | $74.13 | $128.82 | $162.18 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $309.03 | Professional | None | $131.83 | $194.98 | $309.03 |
Quartz Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Facility | None | $77.62 | $77.62 | $100.00 |
Quartz Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $100.00 | Professional | None | $56.23 | $56.23 | $100.00 |
United Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $199.53 | Facility | None | $60.26 | $81.28 | $199.53 |
United Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $114.82 | Professional | None | $47.86 | $67.61 | $114.82 |
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 $46.77 Median $46.77 Typical High $165.96 | Professional | 52 · Reduced service | $46.77 | $46.77 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $67.61 | Professional | 53 · Discontinued | $18.62 | $18.62 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $50.12 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $33.88 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.41 Median $7.41 Typical High $9.77 | Professional | RR · Rental | $7.41 | $7.41 | $9.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | UE · Used equipment | $54.95 | $54.95 | $60.26 |
Where Wisconsin sits
The same service costs 3.1 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· 6th of 51
$123
HI $174DE $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.