How much rates vary
Facilitymedian $98 · 10th to 90th $62 to $209Professionalmedian $91 · 10th to 90th $45 to $145
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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $257.04 | Professional | None | $69.18 | $69.18 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $109.65 Typical High $162.18 | Facility | None | $97.72 | $109.65 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $120.23 | Professional | None | $51.29 | $97.72 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $194.98 Typical High $407.38 | Facility | None | $61.66 | $194.98 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $181.97 | Professional | None | $44.67 | $67.61 | $181.97 |
DeanCare Setting Facility Modifier None Typical Low $26.30 Median $95.50 Typical High $109.65 | Facility | None | $26.30 | $95.50 | $109.65 |
DeanCare Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $128.82 | Professional | None | $95.50 | $120.23 | $128.82 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $95.50 Typical High $436.52 | Facility | None | $47.86 | $95.50 | $436.52 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $57.54 Typical High $123.03 | Professional | None | $37.15 | $57.54 | $123.03 |
Network Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Network Health Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $165.96 | Professional | None | $69.18 | $89.13 | $165.96 |
Prevea360 Setting Facility Modifier None Typical Low $26.30 Median $95.50 Typical High $109.65 | Facility | None | $26.30 | $95.50 | $109.65 |
Prevea360 Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $95.50 | Professional | None | $54.95 | $93.33 | $95.50 |
Quartz Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $208.93 | Professional | None | $89.13 | $128.82 | $208.93 |
Quartz Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $64.57 | Facility | None | $61.66 | $61.66 | $64.57 |
Quartz Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
United Setting Facility Modifier None Typical Low $41.69 Median $45.71 Typical High $131.83 | Facility | None | $41.69 | $45.71 | $131.83 |
United Setting Professional Modifier None Typical Low $31.62 Median $47.86 Typical High $81.28 | Professional | None | $31.62 | $47.86 | $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 $34.67 Median $34.67 Typical High $128.82 | Professional | 52 · Reduced service | $34.67 | $34.67 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $51.29 | Professional | 53 · Discontinued | $13.80 | $13.80 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $38.90 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $25.70 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $25.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $6.61 | Professional | RR · Rental | $4.90 | $4.90 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $39.81 | Professional | UE · Used equipment | $37.15 | $37.15 | $39.81 |
Where Wisconsin sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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
$91.20
HI $112AZ $44.67
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.