How much rates vary
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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $229.09 | Professional | None | $89.13 | $114.82 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $181.97 Typical High $263.03 | Facility | None | $158.49 | $181.97 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $199.53 | Professional | None | $87.10 | $158.49 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $323.59 Typical High $676.08 | Facility | None | $102.33 | $323.59 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $302.00 | Professional | None | $74.13 | $125.89 | $302.00 |
DeanCare Setting Facility Modifier None Typical Low $45.71 Median $158.49 Typical High $181.97 | Facility | None | $45.71 | $158.49 | $181.97 |
DeanCare Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $229.09 | Professional | None | $173.78 | $218.78 | $229.09 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $741.31 | Facility | None | $79.43 | $158.49 | $741.31 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $204.17 | Professional | None | $69.18 | $100.00 | $204.17 |
Network Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Network Health Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $275.42 | Professional | None | $112.20 | $147.91 | $275.42 |
Prevea360 Setting Facility Modifier None Typical Low $45.71 Median $158.49 Typical High $181.97 | Facility | None | $45.71 | $158.49 | $181.97 |
Prevea360 Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $177.83 | Professional | None | $89.13 | $158.49 | $177.83 |
Quartz Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $354.81 | Professional | None | $154.88 | $223.87 | $354.81 |
Quartz Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $104.71 | Facility | None | $102.33 | $102.33 | $104.71 |
Quartz Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Security Health Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | None | $125.89 | $147.91 | $147.91 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $229.09 | Facility | None | $87.10 | $87.10 | $229.09 |
United Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $134.90 | Professional | None | $54.95 | $77.62 | $134.90 |
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 $57.54 Median $57.54 Typical High $114.82 | Professional | 52 · Reduced service | $57.54 | $57.54 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | 53 · Discontinued | $22.91 | $22.91 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $34.67 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $22.91 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $22.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $11.22 | Professional | RR · Rental | $8.51 | $8.51 | $11.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | UE · Used equipment | $63.10 | $63.10 | $72.44 |
Where Wisconsin sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 11th of 51
$148
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.