How much rates vary
Facilitymedian $4,169 · 10th to 90th $2,138 to $9,120Professionalmedian $3,890 · 10th to 90th $1,905 to $6,310
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 $4,073.80 Median $4,073.80 Typical High $4,073.80 | Facility | None | $4,073.80 | $4,073.80 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $4,073.80 Typical High $6,025.60 | Professional | None | $3,019.95 | $4,073.80 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $4,786.30 Typical High $6,918.31 | Facility | None | $4,168.69 | $4,786.30 | $6,918.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $4,168.69 Typical High $5,248.07 | Professional | None | $2,187.76 | $4,168.69 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $8,511.38 Typical High $17,782.79 | Facility | None | $2,137.96 | $8,511.38 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,630.27 Typical High $7,943.28 | Professional | None | $1,584.89 | $2,630.27 | $7,943.28 |
DeanCare Setting Facility Modifier None Typical Low $1,122.02 Median $4,073.80 Typical High $4,786.30 | Facility | None | $1,122.02 | $4,073.80 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $4,073.80 Median $5,011.87 Typical High $5,370.32 | Professional | None | $4,073.80 | $5,011.87 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $1,905.46 Median $4,073.80 Typical High $18,197.01 | Facility | None | $1,905.46 | $4,073.80 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $19,498.45 | Professional | None | $1,905.46 | $2,630.27 | $19,498.45 |
Network Health Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Network Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,890.45 Typical High $7,244.36 | Professional | None | $2,951.21 | $3,890.45 | $7,244.36 |
Prevea360 Setting Facility Modifier None Typical Low $1,122.02 Median $4,073.80 Typical High $4,786.30 | Facility | None | $1,122.02 | $4,073.80 | $4,786.30 |
Prevea360 Setting Professional Modifier None Typical Low $2,344.23 Median $3,890.45 Typical High $4,073.80 | Professional | None | $2,344.23 | $3,890.45 | $4,073.80 |
Quartz Setting Professional Modifier None Typical Low $3,801.89 Median $5,495.41 Typical High $8,709.64 | Professional | None | $3,801.89 | $5,495.41 | $8,709.64 |
Quartz Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,630.27 | Facility | None | $2,137.96 | $2,137.96 | $2,630.27 |
Quartz Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,584.89 | $2,137.96 |
Security Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,311.31 | $3,890.45 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $5,623.41 | Facility | None | $1,949.84 | $1,949.84 | $5,623.41 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,570.40 Typical High $3,548.13 | Professional | None | $1,445.44 | $2,570.40 | $3,548.13 |
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 $2,041.74 Median $2,041.74 Typical High $3,162.28 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $831.76 Typical High $1,288.25 | Professional | 53 · Discontinued | $831.76 | $831.76 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $616.60 Typical High $954.99 | Professional | 55 · Aftercare only | $616.60 | $616.60 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $645.65 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $645.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $213.80 Median $213.80 Typical High $275.42 | Professional | RR · Rental | $213.80 | $213.80 | $275.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | UE · Used equipment | $1,621.81 | $1,621.81 | $1,819.70 |
Where Wisconsin sits
The same service costs 2.6 times more in Wisconsin 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· 1st of 51
$4,074
WI $4,074DE $1,585
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.