How much rates vary
Facilitymedian $83 · 10th to 90th $36 to $191Professionalmedian $78 · 10th to 90th $31 to $120
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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $114.82 | Professional | None | $58.88 | $58.88 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $95.50 Typical High $138.04 | Facility | None | $83.18 | $95.50 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $83.18 Typical High $104.71 | Professional | None | $41.69 | $83.18 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $169.82 Typical High $346.74 | Facility | None | $36.31 | $169.82 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $158.49 | Professional | None | $26.92 | $40.74 | $158.49 |
DeanCare Setting Facility Modifier None Typical Low $21.88 Median $81.28 Typical High $93.33 | Facility | None | $21.88 | $81.28 | $93.33 |
DeanCare Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $104.71 | Professional | None | $81.28 | $100.00 | $104.71 |
Medica Setting Facility Modifier None Typical Low $40.74 Median $81.28 Typical High $354.81 | Facility | None | $40.74 | $81.28 | $354.81 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $48.98 Typical High $107.15 | Professional | None | $33.11 | $48.98 | $107.15 |
Network Health Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Network Health Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $141.25 | Professional | None | $58.88 | $75.86 | $141.25 |
Prevea360 Setting Facility Modifier None Typical Low $21.88 Median $81.28 Typical High $93.33 | Facility | None | $21.88 | $81.28 | $93.33 |
Prevea360 Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $81.28 | Professional | None | $46.77 | $77.62 | $81.28 |
Quartz Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $169.82 | Professional | None | $74.13 | $109.65 | $169.82 |
Quartz Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $40.74 | Facility | None | $36.31 | $36.31 | $40.74 |
Quartz Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
Security Health Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | None | $64.57 | $75.86 | $75.86 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $109.65 | Facility | None | $38.90 | $38.90 | $109.65 |
United Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $69.18 | Professional | None | $26.92 | $40.74 | $69.18 |
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 $29.51 Median $29.51 Typical High $57.54 | Professional | 52 · Reduced service | $29.51 | $29.51 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $22.91 | Professional | 53 · Discontinued | $12.02 | $12.02 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $17.38 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $11.48 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $11.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $5.37 | Professional | RR · Rental | $4.07 | $4.07 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $32.36 | Professional | UE · Used equipment | $30.20 | $30.20 | $32.36 |
Where Wisconsin sits
The same service costs 2.9 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· 4th of 51
$77.62
HI $91.20DE $31.62
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.