How much rates vary
Facilitymedian $3,890 · 10th to 90th $2,455 to $8,511Professionalmedian $3,631 · 10th to 90th $1,820 to $5,888
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 $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $6,025.60 | Professional | None | $3,801.89 | $3,801.89 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $4,466.84 Typical High $6,456.54 | Facility | None | $3,890.45 | $4,466.84 | $6,456.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $3,890.45 Typical High $4,897.79 | Professional | None | $1,949.84 | $3,890.45 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $7,943.28 Typical High $16,218.10 | Facility | None | $2,454.71 | $7,943.28 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,630.27 Typical High $7,413.10 | Professional | None | $1,819.70 | $2,630.27 | $7,413.10 |
DeanCare Setting Facility Modifier None Typical Low $1,023.29 Median $3,801.89 Typical High $4,365.16 | Facility | None | $1,023.29 | $3,801.89 | $4,365.16 |
DeanCare Setting Professional Modifier None Typical Low $2,187.76 Median $3,801.89 Typical High $4,677.35 | Professional | None | $2,187.76 | $3,801.89 | $4,677.35 |
Medica Setting Facility Modifier None Typical Low $1,778.28 Median $3,801.89 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,801.89 | $16,982.44 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $19,054.61 | Professional | None | $1,778.28 | $2,454.71 | $19,054.61 |
Network Health Setting Facility Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Facility | None | $6,165.95 | $6,165.95 | $6,165.95 |
Network Health Setting Professional Modifier None Typical Low $2,754.23 Median $3,630.78 Typical High $6,760.83 | Professional | None | $2,754.23 | $3,630.78 | $6,760.83 |
Prevea360 Setting Facility Modifier None Typical Low $1,023.29 Median $3,801.89 Typical High $4,365.16 | Facility | None | $1,023.29 | $3,801.89 | $4,365.16 |
Prevea360 Setting Professional Modifier None Typical Low $2,187.76 Median $3,801.89 Typical High $3,890.45 | Professional | None | $2,187.76 | $3,801.89 | $3,890.45 |
Quartz Setting Professional Modifier None Typical Low $3,548.13 Median $5,128.61 Typical High $8,128.31 | Professional | None | $3,548.13 | $5,128.61 | $8,128.31 |
Quartz Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,570.40 | Facility | None | $2,454.71 | $2,454.71 | $2,570.40 |
Quartz Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,819.70 | $1,819.70 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $5,128.61 | Facility | None | $1,698.24 | $1,949.84 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,318.26 | $2,344.23 | $3,311.31 |
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 $1,905.46 Median $1,905.46 Typical High $3,019.95 | Professional | 52 · Reduced service | $1,905.46 | $1,905.46 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Professional | 53 · Discontinued | $758.58 | $758.58 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $575.44 Typical High $912.01 | Professional | 55 · Aftercare only | $575.44 | $575.44 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $380.19 Typical High $602.56 | Professional | 56 · Pre-op care only | $380.19 | $380.19 | $602.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $194.98 Median $194.98 Typical High $549.54 | Professional | RR · Rental | $194.98 | $194.98 | $549.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,445.44 Median $1,445.44 Typical High $1,548.82 | Professional | UE · Used equipment | $1,445.44 | $1,445.44 | $1,548.82 |
Where Wisconsin sits
The same service costs 2.4 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· 3rd of 51
$3,802
HI $4,365DE $1,820
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.