How much rates vary
Facilitymedian $1,096 · 10th to 90th $724 to $2,512Professionalmedian $1,023 · 10th to 90th $537 to $1,660
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 $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $2,691.53 | Professional | None | $776.25 | $776.25 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,819.70 | Facility | None | $1,096.48 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $1,096.48 Typical High $1,380.38 | Professional | None | $602.56 | $1,096.48 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,238.72 Typical High $4,570.88 | Facility | None | $724.44 | $2,238.72 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $891.25 Typical High $2,089.30 | Professional | None | $537.03 | $891.25 | $2,089.30 |
DeanCare Setting Facility Modifier None Typical Low $309.03 Median $1,071.52 Typical High $1,230.27 | Facility | None | $309.03 | $1,071.52 | $1,230.27 |
DeanCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,318.26 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $1,071.52 Typical High $5,011.87 | Facility | None | $537.03 | $1,071.52 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,412.54 | Professional | None | $478.63 | $691.83 | $1,412.54 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Network Health Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,862.09 | Professional | None | $776.25 | $1,000.00 | $1,862.09 |
Prevea360 Setting Facility Modifier None Typical Low $309.03 Median $1,071.52 Typical High $1,230.27 | Facility | None | $309.03 | $1,071.52 | $1,230.27 |
Prevea360 Setting Professional Modifier None Typical Low $616.60 Median $1,047.13 Typical High $1,071.52 | Professional | None | $616.60 | $1,047.13 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,548.82 | $2,454.71 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Facility | None | $724.44 | $724.44 | $851.14 |
Quartz Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $851.14 | Professional | None | $537.03 | $537.03 | $851.14 |
Security Health Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | None | $851.14 | $1,000.00 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
United Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $912.01 | Professional | None | $371.54 | $537.03 | $912.01 |
4 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 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $398.11 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $269.15 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $57.54 Median $57.54 Typical High $75.86 | Professional | RR · Rental | $57.54 | $57.54 | $75.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $436.52 Median $436.52 Typical High $467.74 | Professional | UE · Used equipment | $436.52 | $436.52 | $467.74 |
Where Wisconsin sits
The same service costs 2.0 times more in Montana 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· 8th of 51
$1,023
MT $1,096WV $537
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.