How much rates vary
Facilitymedian $126 · 10th to 90th $74 to $269Professionalmedian $115 · 10th to 90th $54 to $186
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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $346.74 | Professional | None | $89.13 | $89.13 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $141.25 Typical High $204.17 | Facility | None | $125.89 | $141.25 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $158.49 | Professional | None | $69.18 | $125.89 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $251.19 Typical High $524.81 | Facility | None | $74.13 | $251.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $234.42 | Professional | None | $53.70 | $81.28 | $234.42 |
DeanCare Setting Facility Modifier None Typical Low $38.02 Median $123.03 Typical High $141.25 | Facility | None | $38.02 | $123.03 | $141.25 |
DeanCare Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $173.78 | Professional | None | $134.90 | $165.96 | $173.78 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $123.03 Typical High $616.60 | Facility | None | $61.66 | $123.03 | $616.60 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $158.49 | Professional | None | $54.95 | $77.62 | $158.49 |
Network Health Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Network Health Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $213.80 | Professional | None | $89.13 | $114.82 | $213.80 |
Prevea360 Setting Facility Modifier None Typical Low $38.02 Median $123.03 Typical High $141.25 | Facility | None | $38.02 | $123.03 | $141.25 |
Prevea360 Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $158.49 | Professional | None | $70.79 | $123.03 | $158.49 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $295.12 | Professional | None | $125.89 | $186.21 | $295.12 |
Quartz Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $81.28 | Facility | None | $74.13 | $74.13 | $81.28 |
Quartz Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $74.13 | Professional | None | $53.70 | $53.70 | $74.13 |
United Setting Facility Modifier None Typical Low $77.62 Median $79.43 Typical High $190.55 | Facility | None | $77.62 | $79.43 | $190.55 |
United Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $107.15 | Professional | None | $45.71 | $64.57 | $107.15 |
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 $44.67 Median $44.67 Typical High $173.78 | Professional | 52 · Reduced service | $44.67 | $44.67 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $69.18 | Professional | 53 · Discontinued | $17.78 | $17.78 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $52.48 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $34.67 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $34.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $19.95 | Professional | RR · Rental | $6.92 | $6.92 | $19.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | UE · Used equipment | $51.29 | $51.29 | $51.29 |
Where Wisconsin sits
The same service costs 3.1 times more in Hawaii than in Florida. 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· 10th of 51
$115
HI $170FL $54.95
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.