How much rates vary
Facilitymedian $575 · 10th to 90th $363 to $1,230Professionalmedian $550 · 10th to 90th $263 to $851
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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $891.25 | Professional | None | $562.34 | $562.34 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $645.65 Typical High $933.25 | Facility | None | $575.44 | $645.65 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $575.44 Typical High $707.95 | Professional | None | $302.00 | $575.44 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $2,398.83 | Facility | None | $363.08 | $1,148.15 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $1,071.52 | Professional | None | $263.03 | $398.11 | $1,071.52 |
DeanCare Setting Facility Modifier None Typical Low $162.18 Median $562.34 Typical High $645.65 | Facility | None | $162.18 | $562.34 | $645.65 |
DeanCare Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $831.76 | Professional | None | $562.34 | $794.33 | $831.76 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $562.34 Typical High $2,630.27 | Facility | None | $281.84 | $562.34 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $2,818.38 | Professional | None | $263.03 | $371.54 | $2,818.38 |
Network Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Network Health Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $977.24 | Professional | None | $407.38 | $524.81 | $977.24 |
Prevea360 Setting Facility Modifier None Typical Low $162.18 Median $562.34 Typical High $645.65 | Facility | None | $162.18 | $562.34 | $645.65 |
Prevea360 Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $562.34 | Professional | None | $323.59 | $549.54 | $562.34 |
Quartz Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,258.93 | Professional | None | $549.54 | $794.33 | $1,258.93 |
Quartz Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $371.54 | Facility | None | $363.08 | $363.08 | $371.54 |
Quartz Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
United Setting Professional Modifier None Typical Low $208.93 Median $354.81 Typical High $478.63 | Professional | None | $208.93 | $354.81 | $478.63 |
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 $281.84 Median $281.84 Typical High $446.68 | Professional | 52 · Reduced service | $281.84 | $281.84 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $177.83 | Professional | 53 · Discontinued | $112.20 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $134.90 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $89.13 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $89.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.90 Median $30.90 Typical High $39.81 | Professional | RR · Rental | $30.90 | $30.90 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | UE · Used equipment | $229.09 | $229.09 | $245.47 |
Where Wisconsin sits
The same service costs 2.2 times more in Montana 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· 6th of 51
$562
MT $575DE $263
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.