How much rates vary
Facilitymedian $107 · 10th to 90th $62 to $234Professionalmedian $100 · 10th to 90th $48 to $166
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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $218.78 | Professional | None | $66.07 | $77.62 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $123.03 Typical High $177.83 | Facility | None | $107.15 | $123.03 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $107.15 Typical High $134.90 | Professional | None | $57.54 | $107.15 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $208.93 Typical High $457.09 | Facility | None | $61.66 | $208.93 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $204.17 | Professional | None | $44.67 | $67.61 | $204.17 |
DeanCare Setting Facility Modifier None Typical Low $53.70 Median $104.71 Typical High $123.03 | Facility | None | $53.70 | $104.71 | $123.03 |
DeanCare Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $128.82 | Professional | None | $95.50 | $114.82 | $128.82 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $104.71 Typical High $478.63 | Facility | None | $61.66 | $104.71 | $478.63 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $70.79 Typical High $138.04 | Professional | None | $47.86 | $70.79 | $138.04 |
Network Health Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $263.03 | Professional | None | $93.33 | $125.89 | $263.03 |
Prevea360 Setting Facility Modifier None Typical Low $53.70 Median $104.71 Typical High $123.03 | Facility | None | $53.70 | $104.71 | $123.03 |
Prevea360 Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | None | $95.50 | $95.50 | $104.71 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $245.47 | Professional | None | $107.15 | $151.36 | $245.47 |
Quartz Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Facility | None | $60.26 | $61.66 | $61.66 |
Quartz Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
The Alliance Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $239.88 | Professional | None | $123.03 | $181.97 | $239.88 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $154.88 | Facility | None | $72.44 | $72.44 | $154.88 |
United Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $91.20 | Professional | None | $37.15 | $53.70 | $91.20 |
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 $38.90 Median $38.90 Typical High $109.65 | Professional | 52 · Reduced service | $38.90 | $38.90 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $43.65 | Professional | 53 · Discontinued | $15.49 | $15.49 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $33.11 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $21.88 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $21.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $47.86 | Professional | RR · Rental | $5.62 | $5.62 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $47.86 | Professional | UE · Used equipment | $42.66 | $42.66 | $47.86 |
Where Wisconsin sits
The same service costs 2.1 times more in Wisconsin 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· 1st of 51
$100
WI $100NJ $47.86
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.