How much rates vary
Facilitymedian $263 · 10th to 90th $162 to $832Professionalmedian $229 · 10th to 90th $162 to $380
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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $1,000.00 | Professional | None | $162.18 | $162.18 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $263.03 Typical High $380.19 | Facility | None | $229.09 | $263.03 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $288.40 | Professional | None | $213.80 | $229.09 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $831.76 Typical High $1,096.48 | Facility | None | $275.42 | $831.76 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $426.58 | Professional | None | $204.17 | $295.12 | $426.58 |
DeanCare Setting Facility Modifier None Typical Low $83.18 Median $223.87 Typical High $269.15 | Facility | None | $83.18 | $223.87 | $269.15 |
DeanCare Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $380.19 | Professional | None | $223.87 | $331.13 | $380.19 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $251.19 Typical High $1,148.15 | Facility | None | $138.04 | $251.19 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $1,737.80 | Professional | None | $194.98 | $275.42 | $1,737.80 |
Network Health Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $562.34 | Professional | None | $213.80 | $389.05 | $562.34 |
Prevea360 Setting Facility Modifier None Typical Low $83.18 Median $223.87 Typical High $269.15 | Facility | None | $83.18 | $223.87 | $269.15 |
Prevea360 Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $223.87 | Professional | None | $114.82 | $114.82 | $223.87 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $263.03 Typical High $524.81 | Professional | None | $125.89 | $263.03 | $524.81 |
Quartz Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $354.81 | Professional | None | $138.04 | $208.93 | $354.81 |
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 $81.28 Median $81.28 Typical High $501.19 | Professional | 52 · Reduced service | $81.28 | $81.28 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $199.53 | Professional | 53 · Discontinued | $32.36 | $32.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $151.36 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $100.00 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $100.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $26.92 | Professional | RR · Rental | $23.99 | $23.99 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | UE · Used equipment | $177.83 | $177.83 | $177.83 |
Where Wisconsin sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 24th of 51
$229
HI $417UT $162
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.