How much rates vary
Facilitymedian $54 · 10th to 90th $36 to $123Professionalmedian $49 · 10th to 90th $26 to $79
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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $158.49 | Professional | None | $38.02 | $38.02 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $60.26 Typical High $87.10 | Facility | None | $53.70 | $60.26 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $53.70 Typical High $66.07 | Professional | None | $27.54 | $53.70 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $107.15 Typical High $223.87 | Facility | None | $36.31 | $107.15 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $38.90 Typical High $100.00 | Professional | None | $26.30 | $38.90 | $100.00 |
DeanCare Setting Facility Modifier None Typical Low $15.14 Median $52.48 Typical High $60.26 | Facility | None | $15.14 | $52.48 | $60.26 |
DeanCare Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $63.10 | Professional | None | $29.51 | $51.29 | $63.10 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $52.48 Typical High $239.88 | Facility | None | $26.30 | $52.48 | $239.88 |
Medica Setting Professional Modifier None Typical Low $22.91 Median $33.11 Typical High $67.61 | Professional | None | $22.91 | $33.11 | $67.61 |
Network Health Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Network Health Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $91.20 | Professional | None | $38.02 | $48.98 | $91.20 |
Prevea360 Setting Facility Modifier None Typical Low $15.14 Median $52.48 Typical High $60.26 | Facility | None | $15.14 | $52.48 | $60.26 |
Prevea360 Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $52.48 | Professional | None | $29.51 | $51.29 | $52.48 |
Quartz Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $117.49 | Professional | None | $51.29 | $75.86 | $117.49 |
Quartz Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Quartz Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $36.31 | Professional | None | $26.30 | $26.30 | $36.31 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $18.20 Median $25.70 Typical High $44.67 | Professional | None | $18.20 | $25.70 | $44.67 |
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 $19.05 Median $19.05 Typical High $79.43 | Professional | 52 · Reduced service | $19.05 | $19.05 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $32.36 | Professional | 53 · Discontinued | $7.59 | $7.59 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $23.99 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $15.85 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $15.14 | Professional | RR · Rental | $2.75 | $2.75 | $15.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17.38 Median $20.42 Typical High $20.42 | Professional | UE · Used equipment | $17.38 | $20.42 | $20.42 |
Where Wisconsin sits
The same service costs 2.1 times more in Montana than in Alabama. 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
$48.98
MT $54.95AL $26.30
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.