How much rates vary
Facilitymedian $91 · 10th to 90th $58 to $200Professionalmedian $85 · 10th to 90th $43 to $141
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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $141.25 | Professional | None | $57.54 | $66.07 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $104.71 Typical High $151.36 | Facility | None | $91.20 | $104.71 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $123.03 | Professional | None | $54.95 | $91.20 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $186.21 Typical High $223.87 | Facility | None | $57.54 | $186.21 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $173.78 | Professional | None | $42.66 | $57.54 | $173.78 |
DeanCare Setting Facility Modifier None Typical Low $28.84 Median $89.13 Typical High $102.33 | Facility | None | $28.84 | $89.13 | $102.33 |
DeanCare Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $151.36 | Professional | None | $97.72 | $141.25 | $151.36 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $89.13 Typical High $467.74 | Facility | None | $45.71 | $89.13 | $467.74 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $112.20 | Professional | None | $41.69 | $57.54 | $112.20 |
Network Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Network Health Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $158.49 | Professional | None | $64.57 | $85.11 | $158.49 |
Prevea360 Setting Facility Modifier None Typical Low $28.84 Median $89.13 Typical High $102.33 | Facility | None | $28.84 | $89.13 | $102.33 |
Prevea360 Setting Professional Modifier None Typical Low $51.29 Median $89.13 Typical High $102.33 | Professional | None | $51.29 | $89.13 | $102.33 |
Quartz Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $229.09 | Professional | None | $91.20 | $138.04 | $229.09 |
Quartz Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $60.26 | Facility | None | $57.54 | $57.54 | $60.26 |
Quartz Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Security Health Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | None | $72.44 | $85.11 | $85.11 |
The Alliance Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $223.87 | Professional | None | $87.10 | $134.90 | $223.87 |
United Setting Facility Modifier None Typical Low $43.65 Median $51.29 Typical High $147.91 | Facility | None | $43.65 | $51.29 | $147.91 |
United Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $79.43 | Professional | None | $35.48 | $47.86 | $79.43 |
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 $33.11 Median $33.11 Typical High $74.13 | Professional | 52 · Reduced service | $33.11 | $33.11 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $29.51 | Professional | 53 · Discontinued | $13.18 | $13.18 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $22.39 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $14.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $44.67 | Professional | RR · Rental | $5.50 | $5.50 | $44.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | UE · Used equipment | $40.74 | $40.74 | $44.67 |
Where Wisconsin sits
The same service costs 2.6 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· 14th of 51
$85.11
HI $117DE $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.