How much rates vary
Facilitymedian $347 · 10th to 90th $158 to $741Professionalmedian $324 · 10th to 90th $117 to $513
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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $812.83 | Professional | None | $245.47 | $245.47 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $398.11 Typical High $575.44 | Facility | None | $346.74 | $398.11 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $346.74 Typical High $436.52 | Professional | None | $154.88 | $346.74 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $691.83 Typical High $1,445.44 | Facility | None | $158.49 | $691.83 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $660.69 | Professional | None | $117.49 | $169.82 | $660.69 |
DeanCare Setting Facility Modifier None Typical Low $83.18 Median $338.84 Typical High $389.05 | Facility | None | $83.18 | $338.84 | $389.05 |
DeanCare Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $407.38 | Professional | None | $194.98 | $338.84 | $407.38 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $338.84 Typical High $1,412.54 | Facility | None | $169.82 | $338.84 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $436.52 | Professional | None | $128.82 | $194.98 | $436.52 |
Network Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Network Health Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $588.84 | Professional | None | $245.47 | $316.23 | $588.84 |
Prevea360 Setting Facility Modifier None Typical Low $83.18 Median $338.84 Typical High $389.05 | Facility | None | $83.18 | $338.84 | $389.05 |
Prevea360 Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $338.84 | Professional | None | $194.98 | $338.84 | $338.84 |
Quartz Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $645.65 | Professional | None | $281.84 | $457.09 | $645.65 |
Quartz Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $169.82 | Facility | None | $158.49 | $158.49 | $169.82 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
United Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $416.87 | Facility | None | $141.25 | $169.82 | $416.87 |
United Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $288.40 | Professional | None | $112.20 | $169.82 | $288.40 |
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 $123.03 Median $123.03 Typical High $407.38 | Professional | 52 · Reduced service | $123.03 | $123.03 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $162.18 | Professional | 53 · Discontinued | $48.98 | $48.98 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $123.03 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $81.28 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $81.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | RR · Rental | $15.49 | $15.49 | $21.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $125.89 | Professional | UE · Used equipment | $117.49 | $117.49 | $125.89 |
Where Wisconsin sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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
$324
HI $468KS $107
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.