How much rates vary
Facilitymedian $251 · 10th to 90th $170 to $550Professionalmedian $245 · 10th to 90th $123 to $380
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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $467.74 | Professional | None | $245.47 | $245.47 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $288.40 Typical High $416.87 | Facility | None | $251.19 | $288.40 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $316.23 | Professional | None | $138.04 | $251.19 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $512.86 Typical High $1,047.13 | Facility | None | $169.82 | $512.86 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $478.63 | Professional | None | $123.03 | $181.97 | $478.63 |
DeanCare Setting Facility Modifier None Typical Low $72.44 Median $245.47 Typical High $281.84 | Facility | None | $72.44 | $245.47 | $281.84 |
DeanCare Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $302.00 | Professional | None | $141.25 | $245.47 | $302.00 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $245.47 Typical High $1,202.26 | Facility | None | $123.03 | $245.47 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $1,698.24 | Professional | None | $114.82 | $169.82 | $1,698.24 |
Network Health Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Network Health Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $426.58 | Professional | None | $177.83 | $229.09 | $426.58 |
Prevea360 Setting Facility Modifier None Typical Low $72.44 Median $245.47 Typical High $281.84 | Facility | None | $72.44 | $245.47 | $281.84 |
Prevea360 Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $295.12 | Professional | None | $141.25 | $245.47 | $295.12 |
Quartz Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $562.34 | Professional | None | $245.47 | $354.81 | $562.34 |
Quartz Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Quartz Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
United Setting Facility Modifier None Typical Low $147.91 Median $158.49 Typical High $363.08 | Facility | None | $147.91 | $158.49 | $363.08 |
United Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $208.93 | Professional | None | $93.33 | $158.49 | $208.93 |
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 $123.03 Median $123.03 Typical High $234.42 | Professional | 52 · Reduced service | $123.03 | $123.03 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $93.33 | Professional | 53 · Discontinued | $48.98 | $48.98 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $70.79 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $46.77 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $46.77 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $18.20 | Professional | RR · Rental | $13.80 | $13.80 | $18.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | UE · Used equipment | $102.33 | $102.33 | $112.20 |
Where Wisconsin sits
The same service costs 3.5 times more in Hawaii 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· 5th of 51
$245
HI $427DC $120
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.