How much rates vary
Facilitymedian $437 · 10th to 90th $282 to $955Professionalmedian $437 · 10th to 90th $204 to $676
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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $812.83 | Professional | None | $436.52 | $436.52 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $501.19 Typical High $724.44 | Facility | None | $436.52 | $501.19 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $575.44 | Professional | None | $269.15 | $436.52 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $891.25 Typical High $1,862.09 | Facility | None | $281.84 | $891.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $831.76 | Professional | None | $204.17 | $302.00 | $831.76 |
DeanCare Setting Facility Modifier None Typical Low $138.04 Median $436.52 Typical High $501.19 | Facility | None | $138.04 | $436.52 | $501.19 |
DeanCare Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $575.44 | Professional | None | $245.47 | $436.52 | $575.44 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $436.52 Typical High $2,344.23 | Facility | None | $218.78 | $436.52 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $3,388.44 | Professional | None | $199.53 | $309.03 | $3,388.44 |
Network Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Network Health Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $758.58 | Professional | None | $309.03 | $407.38 | $758.58 |
Prevea360 Setting Facility Modifier None Typical Low $138.04 Median $436.52 Typical High $501.19 | Facility | None | $138.04 | $436.52 | $501.19 |
Prevea360 Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $575.44 | Professional | None | $245.47 | $436.52 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,096.48 | Professional | None | $436.52 | $660.69 | $1,096.48 |
Quartz Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Facility | None | $281.84 | $281.84 | $288.40 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | None | $204.17 | $204.17 | $281.84 |
United Setting Facility Modifier None Typical Low $288.40 Median $389.05 Typical High $707.95 | Facility | None | $288.40 | $389.05 | $707.95 |
United Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $380.19 | Professional | None | $177.83 | $288.40 | $380.19 |
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 $213.80 Median $213.80 Typical High $407.38 | Professional | 52 · Reduced service | $213.80 | $213.80 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $162.18 | Professional | 53 · Discontinued | $87.10 | $87.10 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $123.03 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $81.28 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $81.28 |
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 $218.78 | Professional | UE · Used equipment | $199.53 | $199.53 | $218.78 |
Where Wisconsin sits
The same service costs 4.1 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· 11th of 51
$437
HI $832DE $204
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.