How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,738 to $7,244Professionalmedian $3,090 · 10th to 90th $1,549 to $5,012
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 $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $4,677.35 | Professional | None | $2,570.40 | $3,311.31 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $3,801.89 Typical High $5,495.41 | Facility | None | $3,388.44 | $3,801.89 | $5,495.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $3,388.44 Typical High $4,168.69 | Professional | None | $1,698.24 | $3,388.44 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $6,760.83 Typical High $14,125.38 | Facility | None | $1,737.80 | $6,760.83 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $6,309.57 | Professional | None | $1,258.93 | $1,949.84 | $6,309.57 |
DeanCare Setting Facility Modifier None Typical Low $891.25 Median $3,311.31 Typical High $3,801.89 | Facility | None | $891.25 | $3,311.31 | $3,801.89 |
DeanCare Setting Professional Modifier None Typical Low $3,311.31 Median $4,466.84 Typical High $4,677.35 | Professional | None | $3,311.31 | $4,466.84 | $4,677.35 |
Medica Setting Facility Modifier None Typical Low $1,548.82 Median $3,311.31 Typical High $14,791.08 | Facility | None | $1,548.82 | $3,311.31 | $14,791.08 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $16,982.44 | Professional | None | $1,548.82 | $2,137.96 | $16,982.44 |
Network Health Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
Network Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,090.30 Typical High $5,754.40 | Professional | None | $2,398.83 | $3,090.30 | $5,754.40 |
Prevea360 Setting Facility Modifier None Typical Low $891.25 Median $3,311.31 Typical High $3,801.89 | Facility | None | $891.25 | $3,311.31 | $3,801.89 |
Prevea360 Setting Professional Modifier None Typical Low $1,905.46 Median $3,235.94 Typical High $3,311.31 | Professional | None | $1,905.46 | $3,235.94 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $3,090.30 Median $4,466.84 Typical High $7,079.46 | Professional | None | $3,090.30 | $4,466.84 | $7,079.46 |
Quartz Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,949.84 | Facility | None | $1,737.80 | $1,737.80 | $1,949.84 |
Quartz Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,258.93 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $4,570.88 | Facility | None | $1,445.44 | $1,621.81 | $4,570.88 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,148.15 | $2,041.74 | $2,818.38 |
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 $1,659.59 Median $1,659.59 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,659.59 | $1,659.59 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $660.69 Typical High $1,000.00 | Professional | 53 · Discontinued | $660.69 | $660.69 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $489.78 Typical High $741.31 | Professional | 55 · Aftercare only | $489.78 | $489.78 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $331.13 Typical High $501.19 | Professional | 56 · Pre-op care only | $331.13 | $331.13 | $501.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $169.82 Median $169.82 Typical High $478.63 | Professional | RR · Rental | $169.82 | $169.82 | $478.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,258.93 Median $1,258.93 Typical High $1,380.38 | Professional | UE · Used equipment | $1,258.93 | $1,258.93 | $1,380.38 |
Where Wisconsin sits
The same service costs 2.7 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· 4th of 51
$3,162
HI $3,388DE $1,259
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.