How much rates vary
Facilitymedian $4,786 · 10th to 90th $3,388 to $10,471Professionalmedian $4,467 · 10th to 90th $2,455 to $7,244
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 $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $7,413.10 | Professional | None | $4,677.35 | $4,677.35 | $7,413.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $5,495.41 Typical High $7,943.28 | Facility | None | $4,786.30 | $5,495.41 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,511.89 Median $4,786.30 Typical High $5,888.44 | Professional | None | $2,511.89 | $4,786.30 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $9,772.37 Typical High $19,952.62 | Facility | None | $3,388.44 | $9,772.37 | $19,952.62 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $3,715.35 Typical High $9,120.11 | Professional | None | $2,454.71 | $3,715.35 | $9,120.11 |
DeanCare Setting Facility Modifier None Typical Low $1,318.26 Median $4,677.35 Typical High $5,370.32 | Facility | None | $1,318.26 | $4,677.35 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $4,897.79 Median $6,165.95 Typical High $6,456.54 | Professional | None | $4,897.79 | $6,165.95 | $6,456.54 |
Medica Setting Facility Modifier None Typical Low $2,290.87 Median $4,677.35 Typical High $21,379.62 | Facility | None | $2,290.87 | $4,677.35 | $21,379.62 |
Medica Setting Professional Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $23,988.33 | Professional | None | $2,187.76 | $3,162.28 | $23,988.33 |
Network Health Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
Network Health Setting Professional Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $8,317.64 | Professional | None | $3,388.44 | $4,466.84 | $8,317.64 |
Prevea360 Setting Facility Modifier None Typical Low $1,318.26 Median $4,677.35 Typical High $5,370.32 | Facility | None | $1,318.26 | $4,677.35 | $5,370.32 |
Prevea360 Setting Professional Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $4,897.79 | Professional | None | $2,691.53 | $4,677.35 | $4,897.79 |
Quartz Setting Professional Modifier None Typical Low $4,466.84 Median $6,456.54 Typical High $10,232.93 | Professional | None | $4,466.84 | $6,456.54 | $10,232.93 |
Quartz Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
Quartz Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,454.71 | $3,388.44 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $6,606.93 | Facility | None | $2,398.83 | $2,398.83 | $6,606.93 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $3,019.95 Typical High $4,073.80 | Professional | None | $1,698.24 | $3,019.95 | $4,073.80 |
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 $2,344.23 Median $2,344.23 Typical High $3,715.35 | Professional | 52 · Reduced service | $2,344.23 | $2,344.23 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $933.25 Typical High $1,479.11 | Professional | 53 · Discontinued | $933.25 | $933.25 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $707.95 Median $707.95 Typical High $1,122.02 | Professional | 55 · Aftercare only | $707.95 | $707.95 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $467.74 Typical High $741.31 | Professional | 56 · Pre-op care only | $467.74 | $467.74 | $741.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $251.19 Median $251.19 Typical High $323.59 | Professional | RR · Rental | $251.19 | $251.19 | $323.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,905.46 Median $1,905.46 Typical High $2,041.74 | Professional | UE · Used equipment | $1,905.46 | $1,905.46 | $2,041.74 |
Where Wisconsin sits
The same service costs 2.1 times more in Montana than in South Carolina. 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· 4th of 51
$4,677
MT $4,898SC $2,344
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.