How much rates vary
Facilitymedian $282 · 10th to 90th $145 to $603Professionalmedian $263 · 10th to 90th $129 to $417
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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $426.58 | Professional | None | $169.82 | $199.53 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $316.23 Typical High $457.09 | Facility | None | $281.84 | $316.23 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $363.08 | Professional | None | $158.49 | $281.84 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $537.03 Typical High $1,174.90 | Facility | None | $141.25 | $537.03 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $524.81 | Professional | None | $104.71 | $158.49 | $524.81 |
DeanCare Setting Facility Modifier None Typical Low $138.04 Median $275.42 Typical High $316.23 | Facility | None | $138.04 | $275.42 | $316.23 |
DeanCare Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $338.84 | Professional | None | $269.15 | $302.00 | $338.84 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $275.42 Typical High $1,288.25 | Facility | None | $138.04 | $275.42 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $354.81 | Professional | None | $128.82 | $181.97 | $354.81 |
Network Health Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $691.83 | Professional | None | $239.88 | $331.13 | $691.83 |
Prevea360 Setting Facility Modifier None Typical Low $138.04 Median $275.42 Typical High $316.23 | Facility | None | $138.04 | $275.42 | $316.23 |
Prevea360 Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $275.42 | Professional | None | $269.15 | $269.15 | $275.42 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $616.60 | Professional | None | $269.15 | $389.05 | $616.60 |
Quartz Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | None | $141.25 | $141.25 | $144.54 |
Quartz Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
The Alliance Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $616.60 | Professional | None | $316.23 | $457.09 | $616.60 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $234.42 | Professional | None | $95.50 | $138.04 | $234.42 |
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 $100.00 Median $100.00 Typical High $213.80 | Professional | 52 · Reduced service | $100.00 | $100.00 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $85.11 | Professional | 53 · Discontinued | $39.81 | $39.81 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $63.10 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $42.66 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $42.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $19.50 | Professional | RR · Rental | $15.85 | $15.85 | $19.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $125.89 | Professional | UE · Used equipment | $117.49 | $117.49 | $125.89 |
Where Wisconsin sits
The same service costs 2.2 times more in Hawaii 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· 5th of 51
$263
HI $275DE $126
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.