How much rates vary
Facilitymedian $229 · 10th to 90th $141 to $501Professionalmedian $214 · 10th to 90th $102 to $347
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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $616.60 | Professional | None | $165.96 | $165.96 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $263.03 Typical High $380.19 | Facility | None | $229.09 | $263.03 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $295.12 | Professional | None | $134.90 | $229.09 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $467.74 Typical High $977.24 | Facility | None | $141.25 | $467.74 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $436.52 | Professional | None | $102.33 | $154.88 | $436.52 |
DeanCare Setting Facility Modifier None Typical Low $72.44 Median $223.87 Typical High $257.04 | Facility | None | $72.44 | $223.87 | $257.04 |
DeanCare Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $316.23 | Professional | None | $245.47 | $295.12 | $316.23 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $223.87 Typical High $1,258.93 | Facility | None | $114.82 | $223.87 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $302.00 | Professional | None | $104.71 | $144.54 | $302.00 |
Network Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Network Health Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $398.11 | Professional | None | $162.18 | $213.80 | $398.11 |
Prevea360 Setting Facility Modifier None Typical Low $72.44 Median $223.87 Typical High $257.04 | Facility | None | $72.44 | $223.87 | $257.04 |
Prevea360 Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $302.00 | Professional | None | $128.82 | $223.87 | $302.00 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $575.44 | Professional | None | $229.09 | $346.74 | $575.44 |
Quartz Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $151.36 | Facility | None | $141.25 | $141.25 | $151.36 |
Quartz Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Security Health Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | None | $181.97 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $151.36 Median $371.54 Typical High $389.05 | Facility | None | $151.36 | $371.54 | $389.05 |
United Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $199.53 | Professional | None | $89.13 | $114.82 | $199.53 |
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 $83.18 Median $83.18 Typical High $309.03 | Professional | 52 · Reduced service | $83.18 | $83.18 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $123.03 | Professional | 53 · Discontinued | $33.11 | $33.11 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $93.33 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $61.66 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $61.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $53.70 | Professional | RR · Rental | $13.49 | $13.49 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | UE · Used equipment | $100.00 | $100.00 | $100.00 |
Where Wisconsin sits
The same service costs 8.1 times more in Hawaii 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· 9th of 51
$214
HI $832DE $102
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.