How much rates vary
Facilitymedian $10,233 · 10th to 90th $6,607 to $22,387Professionalmedian $9,550 · 10th to 90th $4,786 to $15,488
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 $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $12,882.50 | Professional | None | $10,000.00 | $10,000.00 | $12,882.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $11,748.98 Typical High $16,982.44 | Facility | None | $10,232.93 | $11,748.98 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,897.79 Median $10,232.93 Typical High $12,882.50 | Professional | None | $4,897.79 | $10,232.93 | $12,882.50 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $20,892.96 Typical High $43,651.58 | Facility | None | $6,606.93 | $20,892.96 | $43,651.58 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $7,079.46 Typical High $19,498.45 | Professional | None | $4,786.30 | $7,079.46 | $19,498.45 |
DeanCare Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $11,748.98 | Facility | None | $2,570.40 | $10,000.00 | $11,748.98 |
DeanCare Setting Professional Modifier None Typical Low $5,754.40 Median $9,120.11 Typical High $12,302.69 | Professional | None | $5,754.40 | $9,120.11 | $12,302.69 |
Medica Setting Facility Modifier None Typical Low $4,466.84 Median $10,000.00 Typical High $42,657.95 | Facility | None | $4,466.84 | $10,000.00 | $42,657.95 |
Medica Setting Professional Modifier None Typical Low $4,570.88 Median $6,165.95 Typical High $48,977.88 | Professional | None | $4,570.88 | $6,165.95 | $48,977.88 |
Network Health Setting Facility Modifier None Typical Low $16,218.10 Median $16,218.10 Typical High $16,218.10 | Facility | None | $16,218.10 | $16,218.10 | $16,218.10 |
Network Health Setting Professional Modifier None Typical Low $7,244.36 Median $9,549.93 Typical High $17,782.79 | Professional | None | $7,244.36 | $9,549.93 | $17,782.79 |
Prevea360 Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $11,748.98 | Facility | None | $2,570.40 | $10,000.00 | $11,748.98 |
Prevea360 Setting Professional Modifier None Typical Low $5,754.40 Median $8,912.51 Typical High $10,000.00 | Professional | None | $5,754.40 | $8,912.51 | $10,000.00 |
Quartz Setting Professional Modifier None Typical Low $8,912.51 Median $13,489.63 Typical High $20,417.38 | Professional | None | $8,912.51 | $13,489.63 | $20,417.38 |
Quartz Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,760.83 | Facility | None | $6,606.93 | $6,606.93 | $6,760.83 |
Quartz Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,606.93 | Professional | None | $4,786.30 | $4,786.30 | $6,606.93 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $13,182.57 | Facility | None | $3,801.89 | $4,466.84 | $13,182.57 |
United Setting Professional Modifier None Typical Low $3,388.44 Median $6,025.60 Typical High $8,709.64 | Professional | None | $3,388.44 | $6,025.60 | $8,709.64 |
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 $5,011.87 Median $5,011.87 Typical High $6,456.54 | Professional | 52 · Reduced service | $5,011.87 | $5,011.87 | $6,456.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,041.74 Median $2,041.74 Typical High $2,570.40 | Professional | 53 · Discontinued | $2,041.74 | $2,041.74 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,513.56 Median $1,513.56 Typical High $1,905.46 | Professional | 55 · Aftercare only | $1,513.56 | $1,513.56 | $1,905.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,000.00 Median $1,000.00 Typical High $1,288.25 | Professional | 56 · Pre-op care only | $1,000.00 | $1,000.00 | $1,288.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $489.78 Median $489.78 Typical High $645.65 | Professional | RR · Rental | $489.78 | $489.78 | $645.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,630.78 Median $3,630.78 Typical High $3,981.07 | Professional | UE · Used equipment | $3,630.78 | $3,630.78 | $3,981.07 |
Where Wisconsin sits
The same service costs 2.1 times more in Montana 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· 2nd of 51
$10,000
MT $10,000PA $4,786
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.