How much rates vary
Facilitymedian $309 · 10th to 90th $178 to $676Professionalmedian $288 · 10th to 90th $129 to $468
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 $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $645.65 | Professional | None | $169.82 | $223.87 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $354.81 Typical High $512.86 | Facility | None | $309.03 | $354.81 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $309.03 Typical High $389.05 | Professional | None | $128.82 | $309.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $630.96 Typical High $758.58 | Facility | None | $177.83 | $630.96 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $588.84 | Professional | None | $128.82 | $194.98 | $588.84 |
DeanCare Setting Facility Modifier None Typical Low $85.11 Median $302.00 Typical High $346.74 | Facility | None | $85.11 | $302.00 | $346.74 |
DeanCare Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $416.87 | Professional | None | $331.13 | $398.11 | $416.87 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $302.00 Typical High $1,412.54 | Facility | None | $112.20 | $302.00 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $398.11 | Professional | None | $131.83 | $190.55 | $398.11 |
Network Health Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Network Health Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $537.03 | Professional | None | $218.78 | $288.40 | $537.03 |
Prevea360 Setting Facility Modifier None Typical Low $85.11 Median $302.00 Typical High $346.74 | Facility | None | $85.11 | $302.00 | $346.74 |
Prevea360 Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $354.81 | Professional | None | $173.78 | $302.00 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $676.08 | Professional | None | $295.12 | $426.58 | $676.08 |
Quartz Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $194.98 | Facility | None | $177.83 | $177.83 | $194.98 |
Quartz Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $190.55 | Professional | None | $128.82 | $128.82 | $190.55 |
Security Health Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $288.40 | Professional | None | $239.88 | $288.40 | $288.40 |
The Alliance Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $1,819.70 | Professional | None | $416.87 | $602.56 | $1,819.70 |
United Setting Facility Modifier None Typical Low $177.83 Median $186.21 Typical High $436.52 | Facility | None | $177.83 | $186.21 | $436.52 |
United Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $263.03 | Professional | None | $104.71 | $151.36 | $263.03 |
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 $109.65 Median $109.65 Typical High $323.59 | Professional | 52 · Reduced service | $109.65 | $109.65 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $128.82 | Professional | 53 · Discontinued | $44.67 | $44.67 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $97.72 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $64.57 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $64.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $21.38 | Professional | RR · Rental | $12.59 | $12.59 | $21.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $128.82 | Professional | UE · Used equipment | $93.33 | $93.33 | $128.82 |
Where Wisconsin sits
The same service costs 3.5 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· 7th of 51
$288
HI $457DE $129
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.