How much rates vary
Facilitymedian $389 · 10th to 90th $209 to $692Professionalmedian $363 · 10th to 90th $155 to $575
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 $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $537.03 | Professional | None | $213.80 | $275.42 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $436.52 Typical High $630.96 | Facility | None | $389.05 | $436.52 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $389.05 Typical High $478.63 | Professional | None | $223.87 | $389.05 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $616.60 Typical High $1,621.81 | Facility | None | $208.93 | $616.60 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $724.44 | Professional | None | $154.88 | $234.42 | $724.44 |
DeanCare Setting Facility Modifier None Typical Low $109.65 Median $380.19 Typical High $436.52 | Facility | None | $109.65 | $380.19 | $436.52 |
DeanCare Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $457.09 | Professional | None | $380.19 | $436.52 | $457.09 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $380.19 Typical High $1,778.28 | Facility | None | $190.55 | $380.19 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $489.78 | Professional | None | $165.96 | $239.88 | $489.78 |
Network Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Network Health Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $660.69 | Professional | None | $275.42 | $354.81 | $660.69 |
Prevea360 Setting Facility Modifier None Typical Low $109.65 Median $380.19 Typical High $436.52 | Facility | None | $109.65 | $380.19 | $436.52 |
Prevea360 Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $380.19 | Professional | None | $218.78 | $371.54 | $380.19 |
Quartz Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $851.14 | Professional | None | $371.54 | $537.03 | $851.14 |
Quartz Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Quartz Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $323.59 | Professional | None | $131.83 | $190.55 | $323.59 |
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 $138.04 Median $138.04 Typical High $302.00 | Professional | 52 · Reduced service | $138.04 | $138.04 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $120.23 | Professional | 53 · Discontinued | $54.95 | $54.95 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $91.20 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $60.26 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $26.92 | Professional | RR · Rental | $21.88 | $21.88 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | UE · Used equipment | $165.96 | $165.96 | $177.83 |
Where Wisconsin sits
The same service costs 2.4 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· 6th of 51
$363
HI $380DE $158
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.