How much rates vary
Facilitymedian $407 · 10th to 90th $263 to $891Professionalmedian $407 · 10th to 90th $191 to $646
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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $776.25 | Professional | None | $407.38 | $407.38 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $467.74 Typical High $676.08 | Facility | None | $407.38 | $467.74 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $512.86 | Professional | None | $331.13 | $407.38 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $831.76 Typical High $1,737.80 | Facility | None | $263.03 | $831.76 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $776.25 | Professional | None | $190.55 | $288.40 | $776.25 |
DeanCare Setting Facility Modifier None Typical Low $128.82 Median $407.38 Typical High $467.74 | Facility | None | $128.82 | $407.38 | $467.74 |
DeanCare Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $707.95 | Professional | None | $436.52 | $676.08 | $707.95 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $398.11 Typical High $2,290.87 | Facility | None | $204.17 | $398.11 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $2,691.53 | Professional | None | $186.21 | $295.12 | $2,691.53 |
Network Health Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Network Health Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $707.95 | Professional | None | $288.40 | $380.19 | $707.95 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $407.38 Typical High $467.74 | Facility | None | $128.82 | $407.38 | $467.74 |
Prevea360 Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $524.81 | Professional | None | $229.09 | $407.38 | $524.81 |
Quartz Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $1,023.29 | Professional | None | $407.38 | $616.60 | $1,023.29 |
Quartz Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $269.15 | Facility | None | $263.03 | $263.03 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | None | $190.55 | $190.55 | $263.03 |
Security Health Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | None | $323.59 | $380.19 | $380.19 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $660.69 | Facility | None | $263.03 | $263.03 | $660.69 |
United Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $354.81 | Professional | None | $165.96 | $269.15 | $354.81 |
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 $199.53 Median $199.53 Typical High $389.05 | Professional | 52 · Reduced service | $199.53 | $199.53 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $154.88 | Professional | 53 · Discontinued | $81.28 | $81.28 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $114.82 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $77.62 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $77.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $34.67 | Professional | RR · Rental | $32.36 | $32.36 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | UE · Used equipment | $239.88 | $239.88 | $257.04 |
Where Wisconsin sits
The same service costs 3.0 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· 14th of 51
$407
HI $562DE $191
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.