How much rates vary
Facilitymedian $407 · 10th to 90th $269 to $891Professionalmedian $398 · 10th to 90th $200 to $617
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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $588.84 | Professional | None | $407.38 | $407.38 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $467.74 Typical High $676.08 | Facility | None | $407.38 | $467.74 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $512.86 | Professional | None | $218.78 | $407.38 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $831.76 Typical High $1,737.80 | Facility | None | $269.15 | $831.76 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $776.25 | Professional | None | $199.53 | $302.00 | $776.25 |
DeanCare Setting Facility Modifier None Typical Low $109.65 Median $407.38 Typical High $467.74 | Facility | None | $109.65 | $407.38 | $467.74 |
DeanCare Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $537.03 | Professional | None | $407.38 | $512.86 | $537.03 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $407.38 Typical High $1,737.80 | Facility | None | $186.21 | $407.38 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $1,862.09 | Professional | None | $186.21 | $257.04 | $1,862.09 |
Network Health Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Network Health Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $707.95 | Professional | None | $288.40 | $380.19 | $707.95 |
Prevea360 Setting Facility Modifier None Typical Low $109.65 Median $407.38 Typical High $467.74 | Facility | None | $109.65 | $407.38 | $467.74 |
Prevea360 Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $407.38 | Professional | None | $229.09 | $346.74 | $407.38 |
Quartz Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $851.14 | Professional | None | $371.54 | $537.03 | $851.14 |
Quartz Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
United Setting Facility Modifier None Typical Low $158.49 Median $173.78 Typical High $549.54 | Facility | None | $158.49 | $173.78 | $549.54 |
United Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $346.74 | Professional | None | $141.25 | $245.47 | $346.74 |
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 $199.53 Median $199.53 Typical High $309.03 | Professional | 52 · Reduced service | $199.53 | $199.53 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $123.03 | Professional | 53 · Discontinued | $81.28 | $81.28 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $93.33 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $61.66 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $61.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.38 Median $21.38 Typical High $26.92 | Professional | RR · Rental | $21.38 | $21.38 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | UE · Used equipment | $162.18 | $162.18 | $173.78 |
Where Wisconsin sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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
$407
WI $407CO $200
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.