How much rates vary
Facilitymedian $204 · 10th to 90th $126 to $457Professionalmedian $191 · 10th to 90th $95 to $324
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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $436.52 | Professional | None | $120.23 | $147.91 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $234.42 Typical High $338.84 | Facility | None | $204.17 | $234.42 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $269.15 | Professional | None | $120.23 | $204.17 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $870.96 | Facility | None | $125.89 | $398.11 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $389.05 | Professional | None | $93.33 | $141.25 | $389.05 |
DeanCare Setting Facility Modifier None Typical Low $102.33 Median $204.17 Typical High $234.42 | Facility | None | $102.33 | $204.17 | $234.42 |
DeanCare Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $245.47 | Professional | None | $194.98 | $218.78 | $245.47 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $204.17 Typical High $933.25 | Facility | None | $123.03 | $204.17 | $933.25 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $1,000.00 | Professional | None | $95.50 | $134.90 | $1,000.00 |
Network Health Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $501.19 | Professional | None | $177.83 | $239.88 | $501.19 |
Prevea360 Setting Facility Modifier None Typical Low $102.33 Median $204.17 Typical High $234.42 | Facility | None | $102.33 | $204.17 | $234.42 |
Prevea360 Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $204.17 | Professional | None | $194.98 | $194.98 | $204.17 |
Quartz Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $457.09 | Professional | None | $199.53 | $288.40 | $457.09 |
Quartz Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Facility | None | $107.15 | $125.89 | $125.89 |
Quartz Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
The Alliance Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $446.68 | Professional | None | $234.42 | $338.84 | $446.68 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $177.83 | Professional | None | $70.79 | $100.00 | $177.83 |
8 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 $74.13 Median $74.13 Typical High $257.04 | Professional | 52 · Reduced service | $74.13 | $74.13 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $102.33 | Professional | 53 · Discontinued | $29.51 | $29.51 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $77.62 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $51.29 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $14.45 | Professional | RR · Rental | $11.48 | $11.48 | $14.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | UE · Used equipment | $87.10 | $87.10 | $93.33 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $21.38 | Professional | RR · Rental | $10.72 | $10.72 | $21.38 |
Quartz Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Where Wisconsin sits
The same service costs 2.1 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· 5th of 51
$191
HI $200DE $93.33
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.