How much rates vary
Facilitymedian $240 · 10th to 90th $138 to $525Professionalmedian $234 · 10th to 90th $110 to $363
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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $371.54 | Professional | None | $186.21 | $234.42 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $275.42 Typical High $398.11 | Facility | None | $239.88 | $275.42 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $302.00 | Professional | None | $134.90 | $239.88 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $489.78 Typical High $1,023.29 | Facility | None | $138.04 | $489.78 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $457.09 | Professional | None | $102.33 | $154.88 | $457.09 |
DeanCare Setting Facility Modifier None Typical Low $70.79 Median $234.42 Typical High $269.15 | Facility | None | $70.79 | $234.42 | $269.15 |
DeanCare Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $346.74 | Professional | None | $257.04 | $331.13 | $346.74 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $234.42 Typical High $1,174.90 | Facility | None | $120.23 | $234.42 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $1,479.11 | Professional | None | $109.65 | $165.96 | $1,479.11 |
Network Health Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Network Health Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $416.87 | Professional | None | $169.82 | $223.87 | $416.87 |
Prevea360 Setting Facility Modifier None Typical Low $70.79 Median $234.42 Typical High $269.15 | Facility | None | $70.79 | $234.42 | $269.15 |
Prevea360 Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $295.12 | Professional | None | $134.90 | $234.42 | $295.12 |
Quartz Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $562.34 | Professional | None | $239.88 | $354.81 | $562.34 |
Quartz Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $154.88 | Facility | None | $138.04 | $138.04 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | None | $102.33 | $102.33 | $138.04 |
United Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $363.08 | Facility | None | $147.91 | $154.88 | $363.08 |
United Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $204.17 | Professional | None | $93.33 | $158.49 | $204.17 |
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 $117.49 Median $117.49 Typical High $199.53 | Professional | 52 · Reduced service | $117.49 | $117.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $79.43 | Professional | 53 · Discontinued | $46.77 | $46.77 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $58.88 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $39.81 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $39.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $17.78 | Professional | RR · Rental | $13.49 | $13.49 | $17.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | UE · Used equipment | $100.00 | $100.00 | $134.90 |
Where Wisconsin sits
The same service costs 3.5 times more in Hawaii 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· 7th of 51
$234
HI $363DE $102
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.