How much rates vary
Facilitymedian $68 · 10th to 90th $37 to $155Professionalmedian $62 · 10th to 90th $30 to $100
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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $181.97 | Professional | None | $47.86 | $47.86 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $75.86 Typical High $109.65 | Facility | None | $67.61 | $75.86 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $67.61 Typical High $83.18 | Professional | None | $34.67 | $67.61 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $134.90 Typical High $281.84 | Facility | None | $37.15 | $134.90 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $125.89 | Professional | None | $26.92 | $40.74 | $125.89 |
DeanCare Setting Facility Modifier None Typical Low $19.05 Median $66.07 Typical High $75.86 | Facility | None | $19.05 | $66.07 | $75.86 |
DeanCare Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $104.71 | Professional | None | $66.07 | $100.00 | $104.71 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $66.07 Typical High $309.03 | Facility | None | $33.11 | $66.07 | $309.03 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $41.69 Typical High $85.11 | Professional | None | $28.84 | $41.69 | $85.11 |
Network Health Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Network Health Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $114.82 | Professional | None | $47.86 | $61.66 | $114.82 |
Prevea360 Setting Facility Modifier None Typical Low $19.05 Median $66.07 Typical High $75.86 | Facility | None | $19.05 | $66.07 | $75.86 |
Prevea360 Setting Professional Modifier None Typical Low $38.02 Median $64.57 Typical High $66.07 | Professional | None | $38.02 | $64.57 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $147.91 | Professional | None | $64.57 | $93.33 | $147.91 |
Quartz Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Quartz Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | None | $26.92 | $26.92 | $37.15 |
Security Health Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $61.66 | Professional | None | $52.48 | $61.66 | $61.66 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $22.91 Median $33.11 Typical High $56.23 | Professional | None | $22.91 | $33.11 | $56.23 |
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 $23.99 Median $23.99 Typical High $91.20 | Professional | 52 · Reduced service | $23.99 | $23.99 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $36.31 | Professional | 53 · Discontinued | $9.55 | $9.55 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $27.54 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $18.20 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $18.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.47 Typical High $34.67 | Professional | RR · Rental | $3.47 | $3.47 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | UE · Used equipment | $25.70 | $25.70 | $34.67 |
Where Wisconsin sits
The same service costs 2.6 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· 7th of 51
$63.10
MT $69.18DE $26.92
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.