How much rates vary
Facilitymedian $141 · 10th to 90th $91 to $309Professionalmedian $132 · 10th to 90th $66 to $214
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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $302.00 | Professional | None | $102.33 | $102.33 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $162.18 Typical High $234.42 | Facility | None | $141.25 | $162.18 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $141.25 Typical High $186.21 | Professional | None | $81.28 | $141.25 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $288.40 Typical High $602.56 | Facility | None | $91.20 | $288.40 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $269.15 | Professional | None | $66.07 | $97.72 | $269.15 |
DeanCare Setting Facility Modifier None Typical Low $44.67 Median $138.04 Typical High $162.18 | Facility | None | $44.67 | $138.04 | $162.18 |
DeanCare Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $199.53 | Professional | None | $151.36 | $186.21 | $199.53 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $138.04 Typical High $707.95 | Facility | None | $70.79 | $138.04 | $707.95 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $181.97 | Professional | None | $64.57 | $85.11 | $181.97 |
Network Health Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Network Health Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $245.47 | Professional | None | $100.00 | $131.83 | $245.47 |
Prevea360 Setting Facility Modifier None Typical Low $44.67 Median $138.04 Typical High $162.18 | Facility | None | $44.67 | $138.04 | $162.18 |
Prevea360 Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $138.04 | Professional | None | $79.43 | $79.43 | $138.04 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $354.81 | Professional | None | $141.25 | $213.80 | $354.81 |
Quartz Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $93.33 | Facility | None | $91.20 | $91.20 | $93.33 |
Quartz Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $229.09 | Facility | None | $39.81 | $69.18 | $229.09 |
United Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $123.03 | Professional | None | $54.95 | $70.79 | $123.03 |
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 $51.29 Median $51.29 Typical High $151.36 | Professional | 52 · Reduced service | $51.29 | $51.29 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $60.26 | Professional | 53 · Discontinued | $20.42 | $20.42 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $45.71 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $30.20 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $8.13 Typical High $34.67 | Professional | RR · Rental | $8.13 | $8.13 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $61.66 Typical High $61.66 | Professional | UE · Used equipment | $52.48 | $61.66 | $61.66 |
Where Wisconsin sits
The same service costs 2.5 times more in Montana 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· 10th of 51
$132
MT $162DE $66.07
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.