How much rates vary
Facilitymedian $240 · 10th to 90th $126 to $525Professionalmedian $224 · 10th to 90th $110 to $363
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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $371.54 | Professional | None | $234.42 | $234.42 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $275.42 Typical High $398.11 | Facility | None | $239.88 | $275.42 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $239.88 Typical High $302.00 | Professional | None | $117.49 | $239.88 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $489.78 Typical High $1,023.29 | Facility | None | $125.89 | $489.78 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $457.09 | Professional | None | $93.33 | $141.25 | $457.09 |
DeanCare Setting Facility Modifier None Typical Low $61.66 Median $234.42 Typical High $269.15 | Facility | None | $61.66 | $234.42 | $269.15 |
DeanCare Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $281.84 | Professional | None | $239.88 | $263.03 | $281.84 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $234.42 Typical High $1,047.13 | Facility | None | $107.15 | $234.42 | $1,047.13 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $1,230.27 | Professional | None | $109.65 | $147.91 | $1,230.27 |
Network Health Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Network Health Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $416.87 | Professional | None | $169.82 | $223.87 | $416.87 |
Prevea360 Setting Facility Modifier None Typical Low $61.66 Median $234.42 Typical High $269.15 | Facility | None | $61.66 | $234.42 | $269.15 |
Prevea360 Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $239.88 | Professional | None | $134.90 | $234.42 | $239.88 |
Quartz Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $489.78 | Professional | None | $213.80 | $316.23 | $489.78 |
Quartz Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $141.25 | Facility | None | $125.89 | $125.89 | $141.25 |
Quartz Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
United Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $316.23 | Facility | None | $100.00 | $120.23 | $316.23 |
United Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $204.17 | Professional | None | $79.43 | $144.54 | $204.17 |
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 $117.49 Median $117.49 Typical High $186.21 | Professional | 52 · Reduced service | $117.49 | $117.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $74.13 | Professional | 53 · Discontinued | $47.86 | $47.86 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $56.23 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $37.15 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.75 Median $11.75 Typical High $15.85 | Professional | RR · Rental | $11.75 | $11.75 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $89.13 Typical High $95.50 | Professional | UE · Used equipment | $89.13 | $89.13 | $95.50 |
Where Wisconsin sits
The same service costs 2.9 times more in Hawaii than in Florida. 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
$234
HI $269FL $93.33
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.