How much rates vary
Facilitymedian $65 · 10th to 90th $41 to $138Professionalmedian $60 · 10th to 90th $30 to $98
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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $186.21 | Professional | None | $45.71 | $45.71 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $74.13 Typical High $107.15 | Facility | None | $64.57 | $74.13 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $64.57 Typical High $81.28 | Professional | None | $37.15 | $64.57 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $131.83 Typical High $269.15 | Facility | None | $40.74 | $131.83 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $43.65 Typical High $123.03 | Professional | None | $29.51 | $43.65 | $123.03 |
DeanCare Setting Facility Modifier None Typical Low $19.95 Median $63.10 Typical High $72.44 | Facility | None | $19.95 | $63.10 | $72.44 |
DeanCare Setting Professional Modifier None Typical Low $36.31 Median $63.10 Typical High $75.86 | Professional | None | $36.31 | $63.10 | $75.86 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $63.10 Typical High $323.59 | Facility | None | $31.62 | $63.10 | $323.59 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $39.81 Typical High $81.28 | Professional | None | $28.84 | $39.81 | $81.28 |
Network Health Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Network Health Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $109.65 | Professional | None | $45.71 | $58.88 | $109.65 |
Prevea360 Setting Facility Modifier None Typical Low $19.95 Median $63.10 Typical High $72.44 | Facility | None | $19.95 | $63.10 | $72.44 |
Prevea360 Setting Professional Modifier None Typical Low $36.31 Median $63.10 Typical High $72.44 | Professional | None | $36.31 | $63.10 | $72.44 |
Quartz Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $158.49 | Professional | None | $64.57 | $95.50 | $158.49 |
Quartz Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $42.66 | Facility | None | $40.74 | $40.74 | $42.66 |
Quartz Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
United Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $102.33 | Facility | None | $36.31 | $40.74 | $102.33 |
United Setting Professional Modifier None Typical Low $24.55 Median $33.11 Typical High $56.23 | Professional | None | $24.55 | $33.11 | $56.23 |
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 $22.91 Median $22.91 Typical High $93.33 | Professional | 52 · Reduced service | $22.91 | $22.91 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $37.15 | Professional | 53 · Discontinued | $9.12 | $9.12 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $28.18 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $18.62 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $18.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.72 Median $3.72 Typical High $10.00 | Professional | RR · Rental | $3.72 | $3.72 | $10.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.44 Median $27.54 Typical High $27.54 | Professional | UE · Used equipment | $23.44 | $27.54 | $27.54 |
Where Wisconsin sits
The same service costs 2.7 times more in Montana 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· 15th of 51
$60.26
MT $83.18DE $30.90
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.