How much rates vary
Facilitymedian $120 · 10th to 90th $68 to $257Professionalmedian $110 · 10th to 90th $50 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 $64.57 Median $85.11 Typical High $173.78 | Professional | None | $64.57 | $85.11 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $134.90 Typical High $194.98 | Facility | None | $120.23 | $134.90 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $120.23 Typical High $147.91 | Professional | None | $63.10 | $120.23 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $239.88 Typical High $501.19 | Facility | None | $67.61 | $239.88 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $223.87 | Professional | None | $50.12 | $75.86 | $223.87 |
DeanCare Setting Facility Modifier None Typical Low $32.36 Median $117.49 Typical High $134.90 | Facility | None | $32.36 | $117.49 | $134.90 |
DeanCare Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $158.49 | Professional | None | $128.82 | $151.36 | $158.49 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $117.49 Typical High $537.03 | Facility | None | $33.88 | $117.49 | $537.03 |
Medica Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $151.36 | Professional | None | $46.77 | $72.44 | $151.36 |
Network Health Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Network Health Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $204.17 | Professional | None | $85.11 | $109.65 | $204.17 |
Prevea360 Setting Facility Modifier None Typical Low $32.36 Median $117.49 Typical High $134.90 | Facility | None | $32.36 | $117.49 | $134.90 |
Prevea360 Setting Professional Modifier None Typical Low $66.07 Median $117.49 Typical High $134.90 | Professional | None | $66.07 | $117.49 | $134.90 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $257.04 | Professional | None | $112.20 | $158.49 | $257.04 |
Quartz Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $75.86 | Facility | None | $67.61 | $67.61 | $75.86 |
Quartz Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $72.44 | Professional | None | $50.12 | $50.12 | $72.44 |
Security Health Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | None | $93.33 | $109.65 | $109.65 |
The Alliance Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $251.19 | Professional | None | $97.72 | $151.36 | $251.19 |
United Setting Facility Modifier None Typical Low $67.61 Median $77.62 Typical High $165.96 | Facility | None | $67.61 | $77.62 | $165.96 |
United Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $100.00 | Professional | None | $38.90 | $57.54 | $100.00 |
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 $42.66 Median $42.66 Typical High $95.50 | Professional | 52 · Reduced service | $42.66 | $42.66 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $38.02 | Professional | 53 · Discontinued | $16.98 | $16.98 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $28.84 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $19.05 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $19.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $7.94 | Professional | RR · Rental | $6.17 | $6.17 | $7.94 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | UE · Used equipment | $45.71 | $45.71 | $60.26 |
Where Wisconsin sits
The same service costs 4.1 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· 3rd of 51
$110
HI $209DE $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.