How much rates vary
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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $912.01 | Professional | None | $245.47 | $245.47 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $389.05 Typical High $562.34 | Facility | None | $346.74 | $389.05 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $346.74 Typical High $426.58 | Professional | None | $181.97 | $346.74 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $691.83 Typical High $1,445.44 | Facility | None | $218.78 | $691.83 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $645.65 | Professional | None | $158.49 | $234.42 | $645.65 |
DeanCare Setting Facility Modifier None Typical Low $97.72 Median $338.84 Typical High $389.05 | Facility | None | $97.72 | $338.84 | $389.05 |
DeanCare Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $416.87 | Professional | None | $363.08 | $398.11 | $416.87 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $338.84 Typical High $1,621.81 | Facility | None | $169.82 | $338.84 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $436.52 | Professional | None | $138.04 | $204.17 | $436.52 |
Network Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Network Health Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $588.84 | Professional | None | $245.47 | $316.23 | $588.84 |
Prevea360 Setting Facility Modifier None Typical Low $97.72 Median $338.84 Typical High $389.05 | Facility | None | $97.72 | $338.84 | $389.05 |
Prevea360 Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $398.11 | Professional | None | $194.98 | $338.84 | $398.11 |
Quartz Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $758.58 | Professional | None | $331.13 | $478.63 | $758.58 |
Quartz Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $229.09 | Facility | None | $218.78 | $218.78 | $229.09 |
Quartz Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Security Health Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | None | $269.15 | $316.23 | $316.23 |
United Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $489.78 | Facility | None | $199.53 | $204.17 | $489.78 |
United Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $288.40 | Professional | None | $117.49 | $169.82 | $288.40 |
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 $123.03 Median $123.03 Typical High $457.09 | Professional | 52 · Reduced service | $123.03 | $123.03 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $186.21 | Professional | 53 · Discontinued | $48.98 | $48.98 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $138.04 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $91.20 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $91.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $23.99 | Professional | RR · Rental | $18.20 | $18.20 | $23.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | UE · Used equipment | $138.04 | $138.04 | $147.91 |
Where Wisconsin sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 5th of 51
$324
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.