How much rates vary
Facilitymedian $76 · 10th to 90th $42 to $178Professionalmedian $71 · 10th to 90th $31 to $115
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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $199.53 | Professional | None | $54.95 | $54.95 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $125.89 | Facility | None | $75.86 | $87.10 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $75.86 Typical High $100.00 | Professional | None | $40.74 | $75.86 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $154.88 Typical High $323.59 | Facility | None | $41.69 | $154.88 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $144.54 | Professional | None | $30.90 | $44.67 | $144.54 |
DeanCare Setting Facility Modifier None Typical Low $21.38 Median $75.86 Typical High $87.10 | Facility | None | $21.38 | $75.86 | $87.10 |
DeanCare Setting Professional Modifier None Typical Low $42.66 Median $72.44 Typical High $91.20 | Professional | None | $42.66 | $72.44 | $91.20 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $75.86 Typical High $346.74 | Facility | None | $38.02 | $75.86 | $346.74 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $97.72 | Professional | None | $33.11 | $47.86 | $97.72 |
Network Health Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Network Health Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $131.83 | Professional | None | $53.70 | $70.79 | $131.83 |
Prevea360 Setting Facility Modifier None Typical Low $21.38 Median $75.86 Typical High $87.10 | Facility | None | $21.38 | $75.86 | $87.10 |
Prevea360 Setting Professional Modifier None Typical Low $42.66 Median $72.44 Typical High $75.86 | Professional | None | $42.66 | $72.44 | $75.86 |
Quartz Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $169.82 | Professional | None | $74.13 | $107.15 | $169.82 |
Quartz Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Quartz Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $26.30 Median $37.15 Typical High $64.57 | Professional | None | $26.30 | $37.15 | $64.57 |
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 $27.54 Median $27.54 Typical High $100.00 | Professional | 52 · Reduced service | $27.54 | $27.54 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $39.81 | Professional | 53 · Discontinued | $10.96 | $10.96 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $30.20 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $19.95 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $5.37 | Professional | RR · Rental | $4.07 | $4.07 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $30.90 Typical High $30.90 | Professional | UE · Used equipment | $26.30 | $30.90 | $30.90 |
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
$70.79
MT $79.43DE $30.90
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.