How much rates vary
Facilitymedian $62 · 10th to 90th $33 to $141Professionalmedian $56 · 10th to 90th $25 to $91
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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $147.91 | Professional | None | $43.65 | $43.65 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $100.00 | Facility | None | $61.66 | $69.18 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $61.66 Typical High $75.86 | Professional | None | $31.62 | $61.66 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $123.03 Typical High $257.04 | Facility | None | $33.11 | $123.03 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $35.48 Typical High $114.82 | Professional | None | $24.55 | $35.48 | $114.82 |
DeanCare Setting Facility Modifier None Typical Low $17.38 Median $60.26 Typical High $69.18 | Facility | None | $17.38 | $60.26 | $69.18 |
DeanCare Setting Professional Modifier None Typical Low $33.88 Median $58.88 Typical High $72.44 | Professional | None | $33.88 | $58.88 | $72.44 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $60.26 Typical High $275.42 | Facility | None | $30.20 | $60.26 | $275.42 |
Medica Setting Professional Modifier None Typical Low $26.30 Median $38.02 Typical High $77.62 | Professional | None | $26.30 | $38.02 | $77.62 |
Network Health Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Network Health Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $104.71 | Professional | None | $43.65 | $56.23 | $104.71 |
Prevea360 Setting Facility Modifier None Typical Low $17.38 Median $60.26 Typical High $69.18 | Facility | None | $17.38 | $60.26 | $69.18 |
Prevea360 Setting Professional Modifier None Typical Low $33.88 Median $58.88 Typical High $60.26 | Professional | None | $33.88 | $58.88 | $60.26 |
Quartz Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $134.90 | Professional | None | $58.88 | $85.11 | $134.90 |
Quartz Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Quartz Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $20.89 Median $29.51 Typical High $51.29 | Professional | None | $20.89 | $29.51 | $51.29 |
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 $21.88 Median $21.88 Typical High $74.13 | Professional | 52 · Reduced service | $21.88 | $21.88 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $29.51 | Professional | 53 · Discontinued | $8.71 | $8.71 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $21.88 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $14.79 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $14.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.16 Median $3.16 Typical High $4.27 | Professional | RR · Rental | $3.16 | $3.16 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $23.99 Typical High $25.70 | Professional | UE · Used equipment | $23.99 | $23.99 | $25.70 |
Where Wisconsin sits
The same service costs 2.8 times more in Kansas 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
$56.23
KS $69.18DE $24.55
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.