How much rates vary
Facilitymedian $468 · 10th to 90th $302 to $1,023Professionalmedian $447 · 10th to 90th $219 to $708
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 $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $776.25 | Professional | None | $467.74 | $467.74 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $537.03 Typical High $776.25 | Facility | None | $467.74 | $537.03 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $467.74 Typical High $588.84 | Professional | None | $245.47 | $467.74 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $954.99 Typical High $1,995.26 | Facility | None | $302.00 | $954.99 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $891.25 | Professional | None | $218.78 | $323.59 | $891.25 |
DeanCare Setting Facility Modifier None Typical Low $131.83 Median $467.74 Typical High $537.03 | Facility | None | $131.83 | $467.74 | $537.03 |
DeanCare Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $562.34 | Professional | None | $263.03 | $467.74 | $562.34 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $467.74 Typical High $2,137.96 | Facility | None | $229.09 | $467.74 | $2,137.96 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $2,511.89 | Professional | None | $213.80 | $309.03 | $2,511.89 |
Network Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Network Health Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $812.83 | Professional | None | $331.13 | $436.52 | $812.83 |
Prevea360 Setting Facility Modifier None Typical Low $131.83 Median $467.74 Typical High $537.03 | Facility | None | $131.83 | $467.74 | $537.03 |
Prevea360 Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $512.86 | Professional | None | $263.03 | $467.74 | $512.86 |
Quartz Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,047.13 | Professional | None | $446.68 | $645.65 | $1,047.13 |
Quartz Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $309.03 | Facility | None | $302.00 | $302.00 | $309.03 |
Quartz Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $660.69 | Facility | None | $251.19 | $251.19 | $660.69 |
United Setting Professional Modifier None Typical Low $169.82 Median $309.03 Typical High $398.11 | Professional | None | $169.82 | $309.03 | $398.11 |
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 $229.09 Median $229.09 Typical High $389.05 | Professional | 52 · Reduced service | $229.09 | $229.09 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $154.88 | Professional | 53 · Discontinued | $93.33 | $93.33 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $114.82 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $77.62 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $77.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | RR · Rental | $24.55 | $24.55 | $33.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | UE · Used equipment | $181.97 | $181.97 | $199.53 |
Where Wisconsin sits
The same service costs 2.5 times more in Hawaii than in Pennsylvania. 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
$468
HI $550PA $219
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.