How much rates vary
Facilitymedian $380 · 10th to 90th $245 to $832Professionalmedian $380 · 10th to 90th $178 to $589
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 $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $676.08 | Professional | None | $309.03 | $380.19 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $436.52 Typical High $630.96 | Facility | None | $380.19 | $436.52 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $478.63 | Professional | None | $218.78 | $380.19 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $776.25 Typical High $1,621.81 | Facility | None | $245.47 | $776.25 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $724.44 | Professional | None | $177.83 | $269.15 | $724.44 |
DeanCare Setting Facility Modifier None Typical Low $112.20 Median $380.19 Typical High $436.52 | Facility | None | $112.20 | $380.19 | $436.52 |
DeanCare Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $616.60 | Professional | None | $407.38 | $588.84 | $616.60 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $380.19 Typical High $1,862.09 | Facility | None | $190.55 | $380.19 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $2,630.27 | Professional | None | $173.78 | $263.03 | $2,630.27 |
Network Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Network Health Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $660.69 | Professional | None | $269.15 | $354.81 | $660.69 |
Prevea360 Setting Facility Modifier None Typical Low $112.20 Median $380.19 Typical High $436.52 | Facility | None | $112.20 | $380.19 | $436.52 |
Prevea360 Setting Professional Modifier None Typical Low $213.80 Median $380.19 Typical High $467.74 | Professional | None | $213.80 | $380.19 | $467.74 |
Quartz Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $891.25 | Professional | None | $380.19 | $562.34 | $891.25 |
Quartz Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $251.19 | Facility | None | $245.47 | $245.47 | $251.19 |
Quartz Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
United Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $575.44 | Facility | None | $234.42 | $281.84 | $575.44 |
United Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $323.59 | Professional | None | $144.54 | $251.19 | $323.59 |
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 $186.21 Median $186.21 Typical High $354.81 | Professional | 52 · Reduced service | $186.21 | $186.21 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $144.54 | Professional | 53 · Discontinued | $75.86 | $75.86 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $107.15 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $72.44 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $72.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $28.18 | Professional | RR · Rental | $21.88 | $21.88 | $28.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | UE · Used equipment | $162.18 | $162.18 | $177.83 |
Where Wisconsin sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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
$380
HI $646TN $178
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.