How much rates vary
Facilitymedian $245 · 10th to 90th $151 to $562Professionalmedian $229 · 10th to 90th $112 to $363
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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $398.11 | Professional | None | $134.90 | $173.78 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $275.42 Typical High $398.11 | Facility | None | $245.47 | $275.42 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $245.47 Typical High $316.23 | Professional | None | $117.49 | $245.47 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $489.78 Typical High $1,023.29 | Facility | None | $151.36 | $489.78 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $457.09 | Professional | None | $112.20 | $169.82 | $457.09 |
DeanCare Setting Facility Modifier None Typical Low $69.18 Median $239.88 Typical High $275.42 | Facility | None | $69.18 | $239.88 | $275.42 |
DeanCare Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $363.08 | Professional | None | $239.88 | $346.74 | $363.08 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $239.88 Typical High $1,122.02 | Facility | None | $120.23 | $239.88 | $1,122.02 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $309.03 | Professional | None | $104.71 | $151.36 | $309.03 |
Network Health Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Network Health Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $416.87 | Professional | None | $173.78 | $223.87 | $416.87 |
Prevea360 Setting Facility Modifier None Typical Low $69.18 Median $239.88 Typical High $275.42 | Facility | None | $69.18 | $239.88 | $275.42 |
Prevea360 Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $239.88 | Professional | None | $138.04 | $234.42 | $239.88 |
Quartz Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $537.03 | Professional | None | $234.42 | $338.84 | $537.03 |
Quartz Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $154.88 | Facility | None | $151.36 | $151.36 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $154.88 | Professional | None | $112.20 | $112.20 | $154.88 |
Security Health Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $223.87 | Professional | None | $190.55 | $223.87 | $223.87 |
The Alliance Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $204.17 | Professional | None | $83.18 | $120.23 | $204.17 |
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 $87.10 Median $87.10 Typical High $199.53 | Professional | 52 · Reduced service | $87.10 | $87.10 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $81.28 | Professional | 53 · Discontinued | $34.67 | $34.67 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $60.26 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $39.81 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $39.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $16.98 | Professional | RR · Rental | $11.48 | $11.48 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | UE · Used equipment | $85.11 | $85.11 | $93.33 |
Where Wisconsin sits
The same service costs 2.1 times more in Hawaii than in Utah. 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
$229
HI $240UT $112
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.