How much rates vary
Facilitymedian $120 · 10th to 90th $76 to $257Professionalmedian $112 · 10th to 90th $55 to $200
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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $512.86 | Professional | None | $85.11 | $85.11 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $134.90 Typical High $194.98 | Facility | None | $120.23 | $134.90 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $120.23 Typical High $147.91 | Professional | None | $70.79 | $120.23 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $239.88 Typical High $501.19 | Facility | None | $75.86 | $239.88 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $81.28 Typical High $223.87 | Professional | None | $54.95 | $81.28 | $223.87 |
DeanCare Setting Facility Modifier None Typical Low $37.15 Median $117.49 Typical High $134.90 | Facility | None | $37.15 | $117.49 | $134.90 |
DeanCare Setting Professional Modifier None Typical Low $128.82 Median $251.19 Typical High $263.03 | Professional | None | $128.82 | $251.19 | $263.03 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $117.49 Typical High $602.56 | Facility | None | $58.88 | $117.49 | $602.56 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $154.88 | Professional | None | $53.70 | $74.13 | $154.88 |
Network Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Network Health Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $204.17 | Professional | None | $85.11 | $109.65 | $204.17 |
Prevea360 Setting Facility Modifier None Typical Low $37.15 Median $117.49 Typical High $134.90 | Facility | None | $37.15 | $117.49 | $134.90 |
Prevea360 Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $154.88 | Professional | None | $67.61 | $117.49 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $295.12 | Professional | None | $120.23 | $177.83 | $295.12 |
Quartz Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $79.43 | Facility | None | $75.86 | $75.86 | $79.43 |
Quartz Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
United Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $190.55 | Facility | None | $77.62 | $87.10 | $190.55 |
United Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $104.71 | Professional | None | $45.71 | $61.66 | $104.71 |
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 $42.66 Median $42.66 Typical High $257.04 | Professional | 52 · Reduced service | $42.66 | $42.66 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $102.33 | Professional | 53 · Discontinued | $16.98 | $16.98 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $77.62 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $51.29 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.08 Median $7.08 Typical High $39.81 | Professional | RR · Rental | $7.08 | $7.08 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | UE · Used equipment | $52.48 | $52.48 | $52.48 |
Where Wisconsin sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 11th of 51
$112
KS $245VT $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.