How much rates vary
Facilitymedian $214 · 10th to 90th $148 to $490Professionalmedian $200 · 10th to 90th $105 to $316
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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $588.84 | Professional | None | $151.36 | $151.36 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $245.47 Typical High $354.81 | Facility | None | $213.80 | $245.47 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $275.42 | Professional | None | $114.82 | $213.80 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $436.52 Typical High $891.25 | Facility | None | $147.91 | $436.52 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $407.38 | Professional | None | $107.15 | $158.49 | $407.38 |
DeanCare Setting Facility Modifier None Typical Low $60.26 Median $208.93 Typical High $239.88 | Facility | None | $60.26 | $208.93 | $239.88 |
DeanCare Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $275.42 | Professional | None | $208.93 | $263.03 | $275.42 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $208.93 Typical High $977.24 | Facility | None | $104.71 | $208.93 | $977.24 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $269.15 | Professional | None | $93.33 | $131.83 | $269.15 |
Network Health Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Network Health Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $363.08 | Professional | None | $151.36 | $194.98 | $363.08 |
Prevea360 Setting Facility Modifier None Typical Low $60.26 Median $208.93 Typical High $239.88 | Facility | None | $60.26 | $208.93 | $239.88 |
Prevea360 Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $208.93 | Professional | None | $120.23 | $204.17 | $208.93 |
Quartz Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $478.63 | Professional | None | $208.93 | $302.00 | $478.63 |
Quartz Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $309.03 | Facility | None | $102.33 | $102.33 | $309.03 |
United Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $177.83 | Professional | None | $74.13 | $104.71 | $177.83 |
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 $75.86 Median $75.86 Typical High $295.12 | Professional | 52 · Reduced service | $75.86 | $75.86 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $117.49 | Professional | 53 · Discontinued | $30.20 | $30.20 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $89.13 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $58.88 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $58.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $14.79 | Professional | RR · Rental | $11.48 | $11.48 | $14.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | UE · Used equipment | $85.11 | $85.11 | $93.33 |
Where Wisconsin sits
The same service costs 5.4 times more in Kansas 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
$200
KS $575WV $107
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.