How much rates vary
Facilitymedian $562 · 10th to 90th $363 to $1,202Professionalmedian $525 · 10th to 90th $269 to $832
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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $741.31 | Professional | None | $549.54 | $549.54 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $630.96 Typical High $912.01 | Facility | None | $562.34 | $630.96 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $562.34 Typical High $691.83 | Professional | None | $269.15 | $562.34 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,122.02 Typical High $2,344.23 | Facility | None | $363.08 | $1,122.02 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $1,047.13 | Professional | None | $269.15 | $407.38 | $1,047.13 |
DeanCare Setting Facility Modifier None Typical Low $141.25 Median $549.54 Typical High $630.96 | Facility | None | $141.25 | $549.54 | $630.96 |
DeanCare Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $724.44 | Professional | None | $549.54 | $691.83 | $724.44 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $549.54 Typical High $2,344.23 | Facility | None | $245.47 | $549.54 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $2,884.03 | Professional | None | $257.04 | $338.84 | $2,884.03 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Network Health Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $954.99 | Professional | None | $398.11 | $512.86 | $954.99 |
Prevea360 Setting Facility Modifier None Typical Low $141.25 Median $549.54 Typical High $630.96 | Facility | None | $141.25 | $549.54 | $630.96 |
Prevea360 Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $549.54 | Professional | None | $316.23 | $446.68 | $549.54 |
Quartz Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,096.48 | Professional | None | $478.63 | $741.31 | $1,096.48 |
Quartz Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $371.54 | Facility | None | $363.08 | $363.08 | $371.54 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
United Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $707.95 | Facility | None | $165.96 | $223.87 | $707.95 |
United Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $467.74 | Professional | None | $181.97 | $331.13 | $467.74 |
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 $275.42 Median $275.42 Typical High $371.54 | Professional | 52 · Reduced service | $275.42 | $275.42 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $147.91 | Professional | 53 · Discontinued | $109.65 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $112.20 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $74.13 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $74.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $34.67 | Professional | RR · Rental | $26.92 | $26.92 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | UE · Used equipment | $199.53 | $199.53 | $213.80 |
Where Wisconsin sits
The same service costs 2.2 times more in Wisconsin than in Pennsylvania. 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
$550
WI $550PA $245
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.