How much rates vary
Facilitymedian $389 · 10th to 90th $224 to $851Professionalmedian $363 · 10th to 90th $166 to $589
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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $1,096.48 | Professional | None | $281.84 | $281.84 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $446.68 Typical High $645.65 | Facility | None | $389.05 | $446.68 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $389.05 Typical High $489.78 | Professional | None | $173.78 | $389.05 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $794.33 Typical High $1,659.59 | Facility | None | $223.87 | $794.33 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $741.31 | Professional | None | $165.96 | $239.88 | $741.31 |
DeanCare Setting Facility Modifier None Typical Low $93.33 Median $380.19 Typical High $436.52 | Facility | None | $93.33 | $380.19 | $436.52 |
DeanCare Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $467.74 | Professional | None | $218.78 | $380.19 | $467.74 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $380.19 Typical High $1,548.82 | Facility | None | $194.98 | $380.19 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $501.19 | Professional | None | $144.54 | $218.78 | $501.19 |
Network Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Network Health Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $676.08 | Professional | None | $275.42 | $363.08 | $676.08 |
Prevea360 Setting Facility Modifier None Typical Low $93.33 Median $380.19 Typical High $436.52 | Facility | None | $93.33 | $380.19 | $436.52 |
Prevea360 Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $380.19 | Professional | None | $218.78 | $218.78 | $380.19 |
Quartz Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $724.44 | Professional | None | $316.23 | $512.86 | $724.44 |
Quartz Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $239.88 | Facility | None | $223.87 | $223.87 | $239.88 |
Quartz Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | None | $165.96 | $165.96 | $223.87 |
United Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $467.74 | Facility | None | $190.55 | $208.93 | $467.74 |
United Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $331.13 | Professional | None | $128.82 | $190.55 | $331.13 |
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 $141.25 Median $141.25 Typical High $549.54 | Professional | 52 · Reduced service | $141.25 | $141.25 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $218.78 | Professional | 53 · Discontinued | $56.23 | $56.23 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $165.96 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $109.65 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $109.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.38 Median $17.38 Typical High $23.44 | Professional | RR · Rental | $17.38 | $17.38 | $23.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | UE · Used equipment | $131.83 | $131.83 | $141.25 |
Where Wisconsin sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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
$363
HI $525DC $155
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.