How much rates vary
Facilitymedian $63 · 10th to 90th $34 to $145Professionalmedian $58 · 10th to 90th $25 to $95
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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $125.89 | Professional | None | $34.67 | $44.67 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $70.79 Typical High $102.33 | Facility | None | $63.10 | $70.79 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $63.10 Typical High $77.62 | Professional | None | $34.67 | $63.10 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $125.89 Typical High $263.03 | Facility | None | $33.88 | $125.89 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $117.49 | Professional | None | $25.12 | $38.02 | $117.49 |
DeanCare Setting Facility Modifier None Typical Low $17.78 Median $61.66 Typical High $70.79 | Facility | None | $17.78 | $61.66 | $70.79 |
DeanCare Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $83.18 | Professional | None | $61.66 | $79.43 | $83.18 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $61.66 Typical High $288.40 | Facility | None | $30.90 | $61.66 | $288.40 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $38.90 Typical High $79.43 | Professional | None | $26.92 | $38.90 | $79.43 |
Network Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Network Health Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $107.15 | Professional | None | $44.67 | $57.54 | $107.15 |
Prevea360 Setting Facility Modifier None Typical Low $17.78 Median $61.66 Typical High $70.79 | Facility | None | $17.78 | $61.66 | $70.79 |
Prevea360 Setting Professional Modifier None Typical Low $35.48 Median $60.26 Typical High $61.66 | Professional | None | $35.48 | $60.26 | $61.66 |
Quartz Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $138.04 | Professional | None | $60.26 | $87.10 | $138.04 |
Quartz Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Quartz Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $36.31 | Professional | None | $25.12 | $25.12 | $36.31 |
Security Health Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $57.54 | Professional | None | $48.98 | $57.54 | $57.54 |
The Alliance Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $134.90 | Professional | None | $53.70 | $81.28 | $134.90 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $21.38 Median $30.90 Typical High $52.48 | Professional | None | $21.38 | $30.90 | $52.48 |
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 $22.39 Median $22.39 Typical High $74.13 | Professional | 52 · Reduced service | $22.39 | $22.39 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $29.51 | Professional | 53 · Discontinued | $8.91 | $8.91 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $22.39 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $14.79 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $14.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $4.37 | Professional | RR · Rental | $3.31 | $3.31 | $4.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $26.92 Typical High $34.67 | Professional | UE · Used equipment | $25.12 | $26.92 | $34.67 |
Where Wisconsin sits
The same service costs 2.8 times more in Montana 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· 8th of 51
$57.54
MT $64.57KS $23.44
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.