How much rates vary
Facilitymedian $4,074 · 10th to 90th $2,570 to $8,710Professionalmedian $3,802 · 10th to 90th $1,862 to $6,026
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 $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $5,623.41 | Professional | None | $3,981.07 | $3,981.07 | $5,623.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,760.83 | Facility | None | $4,073.80 | $4,570.88 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $4,073.80 Typical High $5,011.87 | Professional | None | $1,862.09 | $4,073.80 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $2,570.40 Median $8,128.31 Typical High $16,982.44 | Facility | None | $2,570.40 | $8,128.31 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $7,762.47 | Professional | None | $1,862.09 | $2,754.23 | $7,762.47 |
DeanCare Setting Facility Modifier None Typical Low $1,000.00 Median $3,981.07 Typical High $4,570.88 | Facility | None | $1,000.00 | $3,981.07 | $4,570.88 |
DeanCare Setting Professional Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $4,786.30 | Professional | None | $2,290.87 | $3,630.78 | $4,786.30 |
Medica Setting Facility Modifier None Typical Low $1,698.24 Median $3,981.07 Typical High $16,218.10 | Facility | None | $1,698.24 | $3,981.07 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $17,378.01 | Professional | None | $1,778.28 | $2,344.23 | $17,378.01 |
Network Health Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Facility | None | $6,456.54 | $6,456.54 | $6,456.54 |
Network Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $6,918.31 | Professional | None | $2,884.03 | $3,715.35 | $6,918.31 |
Prevea360 Setting Facility Modifier None Typical Low $1,000.00 Median $3,981.07 Typical High $4,570.88 | Facility | None | $1,000.00 | $3,981.07 | $4,570.88 |
Prevea360 Setting Professional Modifier None Typical Low $2,290.87 Median $3,311.31 Typical High $3,981.07 | Professional | None | $2,290.87 | $3,311.31 | $3,981.07 |
Quartz Setting Professional Modifier None Typical Low $3,388.44 Median $5,370.32 Typical High $7,762.47 | Professional | None | $3,388.44 | $5,370.32 | $7,762.47 |
Quartz Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,691.53 | Facility | None | $2,570.40 | $2,570.40 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,862.09 | $1,862.09 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $5,011.87 | Facility | None | $1,288.25 | $1,659.59 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,318.26 | $2,290.87 | $3,388.44 |
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 $1,995.26 Median $1,995.26 Typical High $2,818.38 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $1,122.02 | Professional | 53 · Discontinued | $794.33 | $794.33 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $851.14 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $562.34 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $562.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $186.21 Median $186.21 Typical High $245.47 | Professional | RR · Rental | $186.21 | $186.21 | $245.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,412.54 Median $1,412.54 Typical High $1,513.56 | Professional | UE · Used equipment | $1,412.54 | $1,412.54 | $1,513.56 |
Where Wisconsin sits
The same service costs 2.4 times more in Wisconsin 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· 1st of 51
$3,981
WI $3,981DC $1,660
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.