How much rates vary
Facilitymedian $191 · 10th to 90th $120 to $407Professionalmedian $178 · 10th to 90th $87 to $282
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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $489.78 | Professional | None | $134.90 | $134.90 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $213.80 Typical High $309.03 | Facility | None | $190.55 | $213.80 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $245.47 | Professional | None | $100.00 | $190.55 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $380.19 Typical High $794.33 | Facility | None | $120.23 | $380.19 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $354.81 | Professional | None | $87.10 | $131.83 | $354.81 |
DeanCare Setting Facility Modifier None Typical Low $54.95 Median $186.21 Typical High $213.80 | Facility | None | $54.95 | $186.21 | $213.80 |
DeanCare Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $281.84 | Professional | None | $186.21 | $269.15 | $281.84 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $186.21 Typical High $870.96 | Facility | None | $93.33 | $186.21 | $870.96 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $239.88 | Professional | None | $81.28 | $112.20 | $239.88 |
Network Health Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Network Health Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $323.59 | Professional | None | $134.90 | $173.78 | $323.59 |
Prevea360 Setting Facility Modifier None Typical Low $54.95 Median $186.21 Typical High $213.80 | Facility | None | $54.95 | $186.21 | $213.80 |
Prevea360 Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $186.21 | Professional | None | $107.15 | $169.82 | $186.21 |
Quartz Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $426.58 | Professional | None | $186.21 | $269.15 | $426.58 |
Quartz Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Facility | None | $120.23 | $120.23 | $125.89 |
Quartz Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
United Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $275.42 | Facility | None | $72.44 | $85.11 | $275.42 |
United Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $162.18 | Professional | None | $66.07 | $93.33 | $162.18 |
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 $67.61 Median $67.61 Typical High $245.47 | Professional | 52 · Reduced service | $67.61 | $67.61 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $97.72 | Professional | 53 · Discontinued | $26.92 | $26.92 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $72.44 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $48.98 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $48.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $13.49 | Professional | RR · Rental | $10.00 | $10.00 | $13.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | UE · Used equipment | $74.13 | $74.13 | $81.28 |
Where Wisconsin sits
The same service costs 2.4 times more in Montana than in Vermont. 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
$178
MT $209VT $87.10
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.