How much rates vary
Facilitymedian $117 · 10th to 90th $71 to $251Professionalmedian $110 · 10th to 90th $52 to $178
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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $309.03 | Professional | None | $85.11 | $85.11 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $134.90 Typical High $194.98 | Facility | None | $117.49 | $134.90 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $154.88 | Professional | None | $67.61 | $117.49 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $229.09 Typical High $501.19 | Facility | None | $70.79 | $229.09 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $223.87 | Professional | None | $51.29 | $77.62 | $223.87 |
DeanCare Setting Facility Modifier None Typical Low $58.88 Median $114.82 Typical High $131.83 | Facility | None | $58.88 | $114.82 | $131.83 |
DeanCare Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $141.25 | Professional | None | $112.20 | $125.89 | $141.25 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $114.82 Typical High $537.03 | Facility | None | $69.18 | $114.82 | $537.03 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $151.36 | Professional | None | $53.70 | $74.13 | $151.36 |
Network Health Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $288.40 | Professional | None | $102.33 | $144.54 | $288.40 |
Prevea360 Setting Facility Modifier None Typical Low $58.88 Median $114.82 Typical High $131.83 | Facility | None | $58.88 | $114.82 | $131.83 |
Prevea360 Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | None | $112.20 | $112.20 | $114.82 |
Quartz Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $263.03 | Professional | None | $114.82 | $165.96 | $263.03 |
Quartz Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Quartz Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
United Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $169.82 | Facility | None | $57.54 | $63.10 | $169.82 |
United Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $100.00 | Professional | None | $40.74 | $57.54 | $100.00 |
5 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 $42.66 Median $42.66 Typical High $154.88 | Professional | 52 · Reduced service | $42.66 | $42.66 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $46.77 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $30.90 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $30.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $8.13 | Professional | RR · Rental | $6.61 | $6.61 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $50.12 Typical High $61.66 | Professional | UE · Used equipment | $50.12 | $50.12 | $61.66 |
Where Wisconsin sits
The same service costs 2.4 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· 8th of 51
$110
MT $123DE $51.29
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.