How much rates vary
Facilitymedian $178 · 10th to 90th $110 to $389Professionalmedian $166 · 10th to 90th $81 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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $489.78 | Professional | None | $128.82 | $128.82 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $204.17 Typical High $295.12 | Facility | None | $177.83 | $204.17 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $223.87 | Professional | None | $107.15 | $177.83 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $363.08 Typical High $758.58 | Facility | None | $109.65 | $363.08 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $338.84 | Professional | None | $81.28 | $117.49 | $338.84 |
DeanCare Setting Facility Modifier None Typical Low $56.23 Median $177.83 Typical High $204.17 | Facility | None | $56.23 | $177.83 | $204.17 |
DeanCare Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $309.03 | Professional | None | $194.98 | $295.12 | $309.03 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $173.78 Typical High $912.01 | Facility | None | $89.13 | $173.78 | $912.01 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $229.09 | Professional | None | $81.28 | $112.20 | $229.09 |
Network Health Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Network Health Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $309.03 | Professional | None | $128.82 | $165.96 | $309.03 |
Prevea360 Setting Facility Modifier None Typical Low $56.23 Median $177.83 Typical High $204.17 | Facility | None | $56.23 | $177.83 | $204.17 |
Prevea360 Setting Professional Modifier None Typical Low $100.00 Median $177.83 Typical High $213.80 | Professional | None | $100.00 | $177.83 | $213.80 |
Quartz Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $446.68 | Professional | None | $177.83 | $269.15 | $446.68 |
Quartz Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $117.49 | Facility | None | $109.65 | $109.65 | $117.49 |
Quartz Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
United Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $288.40 | Facility | None | $89.13 | $107.15 | $288.40 |
United Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $154.88 | Professional | None | $69.18 | $97.72 | $154.88 |
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 $64.57 Median $64.57 Typical High $245.47 | Professional | 52 · Reduced service | $64.57 | $64.57 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $97.72 | Professional | 53 · Discontinued | $25.70 | $25.70 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $72.44 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $48.98 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $48.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $87.10 | Professional | RR · Rental | $10.72 | $10.72 | $87.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | UE · Used equipment | $81.28 | $81.28 | $87.10 |
Where Wisconsin sits
The same service costs 3.0 times more in Montana 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· 10th of 51
$166
MT $240DE $81.28
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.