How much rates vary
Facilitymedian $39 · 10th to 90th $26 to $89Professionalmedian $36 · 10th to 90th $19 to $59
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 $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $112.20 | Professional | None | $28.18 | $28.18 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $44.67 Typical High $64.57 | Facility | None | $38.90 | $44.67 | $64.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $38.90 Typical High $48.98 | Professional | None | $20.89 | $38.90 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $79.43 Typical High $162.18 | Facility | None | $25.70 | $79.43 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $28.18 Typical High $74.13 | Professional | None | $18.62 | $28.18 | $74.13 |
DeanCare Setting Facility Modifier None Typical Low $10.96 Median $38.02 Typical High $43.65 | Facility | None | $10.96 | $38.02 | $43.65 |
DeanCare Setting Professional Modifier None Typical Low $21.88 Median $37.15 Typical High $46.77 | Professional | None | $21.88 | $37.15 | $46.77 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $38.02 Typical High $177.83 | Facility | None | $19.50 | $38.02 | $177.83 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $24.55 Typical High $50.12 | Professional | None | $16.98 | $24.55 | $50.12 |
Network Health Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Network Health Setting Professional Modifier None Typical Low $27.54 Median $36.31 Typical High $67.61 | Professional | None | $27.54 | $36.31 | $67.61 |
Prevea360 Setting Facility Modifier None Typical Low $10.96 Median $38.02 Typical High $43.65 | Facility | None | $10.96 | $38.02 | $43.65 |
Prevea360 Setting Professional Modifier None Typical Low $21.88 Median $37.15 Typical High $38.02 | Professional | None | $21.88 | $37.15 | $38.02 |
Quartz Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $87.10 | Professional | None | $38.02 | $54.95 | $87.10 |
Quartz Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Quartz Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
Security Health Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $36.31 | Professional | None | $30.90 | $36.31 | $36.31 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $13.49 Median $19.05 Typical High $33.11 | Professional | None | $13.49 | $19.05 | $33.11 |
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 $14.13 Median $14.13 Typical High $56.23 | Professional | 52 · Reduced service | $14.13 | $14.13 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $22.39 | Professional | 53 · Discontinued | $5.62 | $5.62 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $16.98 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $11.22 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $11.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.09 Median $2.09 Typical High $10.96 | Professional | RR · Rental | $2.09 | $2.09 | $10.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | UE · Used equipment | $15.49 | $15.49 | $15.49 |
Where Wisconsin sits
The same service costs 2.2 times more in Montana than in New Jersey. 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
$36.31
MT $40.74NJ $18.62
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.