How much rates vary
Facilitymedian $79 · 10th to 90th $44 to $182Professionalmedian $74 · 10th to 90th $32 to $120
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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $501.19 | Professional | None | $57.54 | $57.54 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $91.20 Typical High $131.83 | Facility | None | $79.43 | $91.20 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $100.00 | Professional | None | $42.66 | $79.43 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $162.18 Typical High $338.84 | Facility | None | $43.65 | $162.18 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $47.86 Typical High $151.36 | Professional | None | $31.62 | $47.86 | $151.36 |
DeanCare Setting Facility Modifier None Typical Low $22.39 Median $77.62 Typical High $89.13 | Facility | None | $22.39 | $77.62 | $89.13 |
DeanCare Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $95.50 | Professional | None | $77.62 | $89.13 | $95.50 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $77.62 Typical High $363.08 | Facility | None | $39.81 | $77.62 | $363.08 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $102.33 | Professional | None | $34.67 | $50.12 | $102.33 |
Network Health Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Network Health Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $138.04 | Professional | None | $56.23 | $74.13 | $138.04 |
Prevea360 Setting Facility Modifier None Typical Low $22.39 Median $77.62 Typical High $89.13 | Facility | None | $22.39 | $77.62 | $89.13 |
Prevea360 Setting Professional Modifier None Typical Low $44.67 Median $75.86 Typical High $77.62 | Professional | None | $44.67 | $75.86 | $77.62 |
Quartz Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $177.83 | Professional | None | $77.62 | $120.23 | $177.83 |
Quartz Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Quartz Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | None | $31.62 | $31.62 | $43.65 |
Security Health Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | None | $63.10 | $74.13 | $74.13 |
United Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $27.54 Median $38.90 Typical High $67.61 | Professional | None | $27.54 | $38.90 | $67.61 |
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 $28.84 Median $28.84 Typical High $251.19 | Professional | 52 · Reduced service | $28.84 | $28.84 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $100.00 | Professional | 53 · Discontinued | $11.48 | $11.48 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $75.86 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $50.12 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $50.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $12.88 | Professional | RR · Rental | $4.27 | $4.27 | $12.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.92 Median $31.62 Typical High $31.62 | Professional | UE · Used equipment | $26.92 | $31.62 | $31.62 |
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
$74.13
MT $83.18DE $31.62
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.