How much rates vary
Facilitymedian $195 · 10th to 90th $107 to $457Professionalmedian $182 · 10th to 90th $79 to $295
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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $407.38 | Professional | None | $141.25 | $141.25 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $223.87 Typical High $323.59 | Facility | None | $194.98 | $223.87 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $194.98 Typical High $245.47 | Professional | None | $100.00 | $194.98 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $398.11 Typical High $831.76 | Facility | None | $107.15 | $398.11 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $371.54 | Professional | None | $79.43 | $120.23 | $371.54 |
DeanCare Setting Facility Modifier None Typical Low $54.95 Median $194.98 Typical High $223.87 | Facility | None | $54.95 | $194.98 | $223.87 |
DeanCare Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $234.42 | Professional | None | $194.98 | $218.78 | $234.42 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $194.98 Typical High $891.25 | Facility | None | $97.72 | $194.98 | $891.25 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $251.19 | Professional | None | $85.11 | $123.03 | $251.19 |
Network Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Network Health Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $338.84 | Professional | None | $138.04 | $181.97 | $338.84 |
Prevea360 Setting Facility Modifier None Typical Low $54.95 Median $194.98 Typical High $223.87 | Facility | None | $54.95 | $194.98 | $223.87 |
Prevea360 Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $194.98 | Professional | None | $109.65 | $190.55 | $194.98 |
Quartz Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $436.52 | Professional | None | $190.55 | $275.42 | $436.52 |
Quartz Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Quartz Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Security Health Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $181.97 | Professional | None | $154.88 | $181.97 | $181.97 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $165.96 | Professional | None | $67.61 | $95.50 | $165.96 |
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 $70.79 Median $70.79 Typical High $204.17 | Professional | 52 · Reduced service | $70.79 | $70.79 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $81.28 | Professional | 53 · Discontinued | $28.18 | $28.18 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $61.66 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $40.74 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $13.80 | Professional | RR · Rental | $10.00 | $10.00 | $13.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $81.28 Typical High $100.00 | Professional | UE · Used equipment | $75.86 | $81.28 | $100.00 |
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· 9th of 51
$182
MT $204DE $79.43
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.