How much rates vary
Facilitymedian $43 · 10th to 90th $23 to $98Professionalmedian $39 · 10th to 90th $17 to $65
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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $125.89 | Professional | None | $30.20 | $30.20 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $47.86 Typical High $69.18 | Facility | None | $42.66 | $47.86 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $42.66 Typical High $52.48 | Professional | None | $13.18 | $42.66 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $85.11 Typical High $177.83 | Facility | None | $22.91 | $85.11 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $25.70 Typical High $79.43 | Professional | None | $16.98 | $25.70 | $79.43 |
DeanCare Setting Facility Modifier None Typical Low $12.02 Median $41.69 Typical High $47.86 | Facility | None | $12.02 | $41.69 | $47.86 |
DeanCare Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $66.07 | Professional | None | $41.69 | $63.10 | $66.07 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $41.69 Typical High $190.55 | Facility | None | $20.89 | $41.69 | $190.55 |
Medica Setting Professional Modifier None Typical Low $18.20 Median $26.30 Typical High $53.70 | Professional | None | $18.20 | $26.30 | $53.70 |
Network Health Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Network Health Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $72.44 | Professional | None | $30.20 | $38.90 | $72.44 |
Prevea360 Setting Facility Modifier None Typical Low $12.02 Median $41.69 Typical High $47.86 | Facility | None | $12.02 | $41.69 | $47.86 |
Prevea360 Setting Professional Modifier None Typical Low $23.44 Median $40.74 Typical High $41.69 | Professional | None | $23.44 | $40.74 | $41.69 |
Quartz Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $93.33 | Professional | None | $40.74 | $58.88 | $93.33 |
Quartz Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Quartz Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Security Health Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $38.90 | Professional | None | $33.11 | $38.90 | $38.90 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $14.45 Median $20.42 Typical High $35.48 | Professional | None | $14.45 | $20.42 | $35.48 |
5 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 $15.14 Median $15.14 Typical High $63.10 | Professional | 52 · Reduced service | $15.14 | $15.14 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $25.12 | Professional | 53 · Discontinued | $6.03 | $6.03 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $19.05 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $12.59 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | UE · Used equipment | $10.00 | $10.00 | $10.00 |
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· 8th of 51
$38.90
MT $43.65DE $16.98
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.