How much rates vary
Facilitymedian $7,413 · 10th to 90th $4,677 to $16,218Professionalmedian $6,918 · 10th to 90th $3,467 to $11,220
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 $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $15,848.93 | Professional | None | $7,244.36 | $7,244.36 | $15,848.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $8,511.38 Typical High $12,302.69 | Facility | None | $7,413.10 | $8,511.38 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,630.78 Median $7,413.10 Typical High $9,332.54 | Professional | None | $3,630.78 | $7,413.10 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $15,135.61 Typical High $31,622.78 | Facility | None | $4,677.35 | $15,135.61 | $31,622.78 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $5,011.87 Typical High $14,125.38 | Professional | None | $3,467.37 | $5,011.87 | $14,125.38 |
DeanCare Setting Facility Modifier None Typical Low $1,949.84 Median $7,244.36 Typical High $8,317.64 | Facility | None | $1,949.84 | $7,244.36 | $8,317.64 |
DeanCare Setting Professional Modifier None Typical Low $4,168.69 Median $7,244.36 Typical High $8,912.51 | Professional | None | $4,168.69 | $7,244.36 | $8,912.51 |
Medica Setting Facility Modifier None Typical Low $3,388.44 Median $7,244.36 Typical High $34,673.69 | Facility | None | $3,388.44 | $7,244.36 | $34,673.69 |
Medica Setting Professional Modifier None Typical Low $3,388.44 Median $4,677.35 Typical High $52,480.75 | Professional | None | $3,388.44 | $4,677.35 | $52,480.75 |
Network Health Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Facility | None | $11,748.98 | $11,748.98 | $11,748.98 |
Network Health Setting Professional Modifier None Typical Low $5,248.07 Median $6,918.31 Typical High $12,882.50 | Professional | None | $5,248.07 | $6,918.31 | $12,882.50 |
Prevea360 Setting Facility Modifier None Typical Low $1,949.84 Median $7,244.36 Typical High $8,317.64 | Facility | None | $1,949.84 | $7,244.36 | $8,317.64 |
Prevea360 Setting Professional Modifier None Typical Low $4,168.69 Median $7,244.36 Typical High $8,128.31 | Professional | None | $4,168.69 | $7,244.36 | $8,128.31 |
Quartz Setting Professional Modifier None Typical Low $6,760.83 Median $9,772.37 Typical High $15,488.17 | Professional | None | $6,760.83 | $9,772.37 | $15,488.17 |
Quartz Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,897.79 | Facility | None | $4,677.35 | $4,677.35 | $4,897.79 |
Quartz Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $4,897.79 Typical High $10,000.00 | Facility | None | $4,073.80 | $4,897.79 | $10,000.00 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $4,570.88 Typical High $6,309.57 | Professional | None | $2,511.89 | $4,570.88 | $6,309.57 |
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 $3,630.78 Median $3,630.78 Typical High $7,943.28 | Professional | 52 · Reduced service | $3,630.78 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,445.44 Median $1,445.44 Typical High $3,162.28 | Professional | 53 · Discontinued | $1,445.44 | $1,445.44 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,096.48 Median $1,096.48 Typical High $2,344.23 | Professional | 55 · Aftercare only | $1,096.48 | $1,096.48 | $2,344.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $724.44 Median $724.44 Typical High $1,584.89 | Professional | 56 · Pre-op care only | $724.44 | $724.44 | $1,584.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | RR · Rental | $363.08 | $363.08 | $501.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,754.23 Median $2,754.23 Typical High $2,951.21 | Professional | UE · Used equipment | $2,754.23 | $2,754.23 | $2,951.21 |
Where Wisconsin sits
The same service costs 3.9 times more in Hawaii than in Washington, DC. 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· 7th of 51
$7,244
HI $12,882DC $3,311
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.