How much rates vary
Facilitymedian $372 · 10th to 90th $229 to $813Professionalmedian $347 · 10th to 90th $174 to $562
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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $645.65 | Professional | None | $346.74 | $363.08 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $426.58 Typical High $616.60 | Facility | None | $371.54 | $426.58 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $457.09 | Professional | None | $218.78 | $371.54 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $758.58 Typical High $1,548.82 | Facility | None | $229.09 | $758.58 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $707.95 | Professional | None | $165.96 | $251.19 | $707.95 |
DeanCare Setting Facility Modifier None Typical Low $117.49 Median $363.08 Typical High $416.87 | Facility | None | $117.49 | $363.08 | $416.87 |
DeanCare Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $549.54 | Professional | None | $380.19 | $524.81 | $549.54 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $1,905.46 | Facility | None | $186.21 | $363.08 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $2,238.72 | Professional | None | $169.82 | $263.03 | $2,238.72 |
Network Health Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Network Health Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $645.65 | Professional | None | $263.03 | $346.74 | $645.65 |
Prevea360 Setting Facility Modifier None Typical Low $117.49 Median $363.08 Typical High $416.87 | Facility | None | $117.49 | $363.08 | $416.87 |
Prevea360 Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $380.19 | Professional | None | $208.93 | $363.08 | $380.19 |
Quartz Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $933.25 | Professional | None | $371.54 | $562.34 | $933.25 |
Quartz Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Facility | None | $229.09 | $229.09 | $245.47 |
Quartz Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
United Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $602.56 | Facility | None | $151.36 | $190.55 | $602.56 |
United Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $323.59 | Professional | None | $151.36 | $245.47 | $323.59 |
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 $181.97 Median $181.97 Typical High $338.84 | Professional | 52 · Reduced service | $181.97 | $181.97 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $134.90 | Professional | 53 · Discontinued | $72.44 | $72.44 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $102.33 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $67.61 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $67.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $28.84 | Professional | RR · Rental | $21.88 | $21.88 | $28.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | UE · Used equipment | $165.96 | $165.96 | $177.83 |
Where Wisconsin sits
The same service costs 2.7 times more in Montana 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· 9th of 51
$363
MT $457DE $170
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.