How much rates vary
Facilitymedian $36 · 10th to 90th $25 to $83Professionalmedian $33 · 10th to 90th $17 to $54
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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $102.33 | Professional | None | $25.70 | $25.70 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $58.88 | Facility | None | $36.31 | $40.74 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $36.31 Typical High $46.77 | Professional | None | $18.62 | $36.31 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $72.44 Typical High $151.36 | Facility | None | $24.55 | $72.44 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $26.92 Typical High $67.61 | Professional | None | $17.78 | $26.92 | $67.61 |
DeanCare Setting Facility Modifier None Typical Low $10.23 Median $35.48 Typical High $40.74 | Facility | None | $10.23 | $35.48 | $40.74 |
DeanCare Setting Professional Modifier None Typical Low $35.48 Median $50.12 Typical High $52.48 | Professional | None | $35.48 | $50.12 | $52.48 |
Medica Setting Facility Modifier None Typical Low $17.78 Median $35.48 Typical High $165.96 | Facility | None | $17.78 | $35.48 | $165.96 |
Medica Setting Professional Modifier None Typical Low $15.49 Median $22.39 Typical High $45.71 | Professional | None | $15.49 | $22.39 | $45.71 |
Network Health Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Network Health Setting Professional Modifier None Typical Low $25.70 Median $33.11 Typical High $61.66 | Professional | None | $25.70 | $33.11 | $61.66 |
Prevea360 Setting Facility Modifier None Typical Low $10.23 Median $35.48 Typical High $40.74 | Facility | None | $10.23 | $35.48 | $40.74 |
Prevea360 Setting Professional Modifier None Typical Low $19.95 Median $34.67 Typical High $35.48 | Professional | None | $19.95 | $34.67 | $35.48 |
Quartz Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $79.43 | Professional | None | $34.67 | $50.12 | $79.43 |
Quartz Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Quartz Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Security Health Setting Professional Modifier None Typical Low $28.18 Median $33.11 Typical High $33.11 | Professional | None | $28.18 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $12.30 Median $17.38 Typical High $30.20 | Professional | None | $12.30 | $17.38 | $30.20 |
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 $12.88 Median $12.88 Typical High $51.29 | Professional | 52 · Reduced service | $12.88 | $12.88 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $20.42 | Professional | 53 · Discontinued | $5.13 | $5.13 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $15.49 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $10.23 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $10.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $18.62 | Professional | RR · Rental | $1.82 | $1.82 | $18.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.80 Median $13.80 Typical High $18.62 | Professional | UE · Used equipment | $13.80 | $13.80 | $18.62 |
Where Wisconsin sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$33.11
MT $37.15WV $17.78
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.