How much rates vary
Facilitymedian $52 · 10th to 90th $36 to $186Professionalmedian $51 · 10th to 90th $36 to $85
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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $223.87 | Professional | None | $36.31 | $36.31 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $58.88 Typical High $85.11 | Facility | None | $51.29 | $58.88 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $64.57 | Professional | None | $47.86 | $51.29 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $186.21 Typical High $245.47 | Facility | None | $52.48 | $186.21 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $95.50 | Professional | None | $44.67 | $57.54 | $95.50 |
DeanCare Setting Facility Modifier None Typical Low $19.05 Median $50.12 Typical High $60.26 | Facility | None | $19.05 | $50.12 | $60.26 |
DeanCare Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $85.11 | Professional | None | $50.12 | $75.86 | $85.11 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $56.23 Typical High $257.04 | Facility | None | $30.90 | $56.23 | $257.04 |
Medica Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $389.05 | Professional | None | $43.65 | $63.10 | $389.05 |
Network Health Setting Professional Modifier None Typical Low $47.86 Median $83.18 Typical High $125.89 | Professional | None | $47.86 | $83.18 | $125.89 |
Prevea360 Setting Facility Modifier None Typical Low $19.05 Median $50.12 Typical High $60.26 | Facility | None | $19.05 | $50.12 | $60.26 |
Prevea360 Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $50.12 | Professional | None | $25.70 | $25.70 | $50.12 |
Quartz Setting Professional Modifier None Typical Low $28.84 Median $58.88 Typical High $117.49 | Professional | None | $28.84 | $58.88 | $117.49 |
Quartz Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Quartz Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $57.54 | Professional | None | $44.67 | $44.67 | $57.54 |
The Alliance Setting Professional Modifier None Typical Low $33.11 Median $52.48 Typical High $97.72 | Professional | None | $33.11 | $52.48 | $97.72 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $81.28 | Professional | None | $30.90 | $46.77 | $81.28 |
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 $18.20 Median $18.20 Typical High $112.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $45.71 | Professional | 53 · Discontinued | $7.24 | $7.24 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $33.88 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $22.39 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $5.75 | Professional | RR · Rental | $5.37 | $5.37 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
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
$51.29
HI $93.33UT $36.31
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.