How much rates vary
Facilitymedian $76 · 10th to 90th $49 to $166Professionalmedian $71 · 10th to 90th $35 to $115
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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $100.00 | Professional | None | $53.70 | $53.70 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $125.89 | Facility | None | $75.86 | $87.10 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $75.86 Typical High $95.50 | Professional | None | $37.15 | $75.86 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $154.88 Typical High $316.23 | Facility | None | $48.98 | $154.88 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $144.54 | Professional | None | $35.48 | $53.70 | $144.54 |
DeanCare Setting Facility Modifier None Typical Low $19.50 Median $74.13 Typical High $85.11 | Facility | None | $19.50 | $74.13 | $85.11 |
DeanCare Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $100.00 | Professional | None | $81.28 | $93.33 | $100.00 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $74.13 Typical High $331.13 | Facility | None | $37.15 | $74.13 | $331.13 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $44.67 Typical High $95.50 | Professional | None | $28.18 | $44.67 | $95.50 |
Network Health Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Network Health Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $128.82 | Professional | None | $53.70 | $69.18 | $128.82 |
Prevea360 Setting Facility Modifier None Typical Low $19.50 Median $74.13 Typical High $85.11 | Facility | None | $19.50 | $74.13 | $85.11 |
Prevea360 Setting Professional Modifier None Typical Low $42.66 Median $74.13 Typical High $81.28 | Professional | None | $42.66 | $74.13 | $81.28 |
Quartz Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $151.36 | Professional | None | $66.07 | $100.00 | $151.36 |
Quartz Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $50.12 | Facility | None | $48.98 | $48.98 | $50.12 |
Quartz Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Security Health Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $69.18 | Professional | None | $58.88 | $69.18 | $69.18 |
United Setting Facility Modifier None Typical Low $40.74 Median $52.48 Typical High $97.72 | Facility | None | $40.74 | $52.48 | $97.72 |
United Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $63.10 | Professional | None | $24.55 | $37.15 | $63.10 |
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 $26.92 Median $26.92 Typical High $50.12 | Professional | 52 · Reduced service | $26.92 | $26.92 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $19.95 | Professional | 53 · Discontinued | $10.96 | $10.96 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $15.14 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $10.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.63 Median $3.63 Typical High $32.36 | Professional | RR · Rental | $3.63 | $3.63 | $32.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $27.54 Typical High $32.36 | Professional | UE · Used equipment | $27.54 | $27.54 | $32.36 |
Where Wisconsin sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 4th of 51
$70.79
HI $132DC $33.11
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.