How much rates vary
Facilitymedian $251 · 10th to 90th $145 to $537Professionalmedian $224 · 10th to 90th $105 to $372
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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $524.81 | Professional | None | $177.83 | $177.83 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $281.84 Typical High $407.38 | Facility | None | $251.19 | $281.84 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $309.03 | Professional | None | $120.23 | $251.19 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $501.19 Typical High $1,047.13 | Facility | None | $144.54 | $501.19 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $467.74 | Professional | None | $104.71 | $154.88 | $467.74 |
DeanCare Setting Facility Modifier None Typical Low $64.57 Median $245.47 Typical High $281.84 | Facility | None | $64.57 | $245.47 | $281.84 |
DeanCare Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $323.59 | Professional | None | $245.47 | $309.03 | $323.59 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $245.47 Typical High $1,071.52 | Facility | None | $123.03 | $245.47 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $316.23 | Professional | None | $93.33 | $147.91 | $316.23 |
Network Health Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Network Health Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $426.58 | Professional | None | $177.83 | $229.09 | $426.58 |
Prevea360 Setting Facility Modifier None Typical Low $64.57 Median $245.47 Typical High $281.84 | Facility | None | $64.57 | $245.47 | $281.84 |
Prevea360 Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $245.47 | Professional | None | $138.04 | $199.53 | $245.47 |
Quartz Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $512.86 | Professional | None | $218.78 | $331.13 | $512.86 |
Quartz Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $154.88 | Facility | None | $144.54 | $144.54 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $323.59 | Facility | None | $87.10 | $100.00 | $323.59 |
United Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $208.93 | Professional | None | $81.28 | $120.23 | $208.93 |
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 $89.13 Median $89.13 Typical High $263.03 | Professional | 52 · Reduced service | $89.13 | $89.13 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $104.71 | Professional | 53 · Discontinued | $35.48 | $35.48 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $79.43 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $52.48 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $52.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | RR · Rental | $12.02 | $12.02 | $16.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | UE · Used equipment | $89.13 | $89.13 | $89.13 |
Where Wisconsin sits
The same service costs 2.5 times more in Montana than in Florida. 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
$229
MT $263FL $105
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.