How much rates vary
Facilitymedian $10,965 · 10th to 90th $7,244 to $23,988Professionalmedian $10,233 · 10th to 90th $5,248 to $16,596
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 $10,715.19 Median $10,715.19 Typical High $10,715.19 | Facility | None | $10,715.19 | $10,715.19 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $14,791.08 | Professional | None | $10,715.19 | $10,715.19 | $14,791.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $12,589.25 Typical High $18,197.01 | Facility | None | $10,964.78 | $12,589.25 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,623.41 Median $10,964.78 Typical High $14,125.38 | Professional | None | $5,623.41 | $10,964.78 | $14,125.38 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $22,387.21 Typical High $45,708.82 | Facility | None | $7,244.36 | $22,387.21 | $45,708.82 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $7,762.47 Typical High $20,892.96 | Professional | None | $5,248.07 | $7,762.47 | $20,892.96 |
DeanCare Setting Facility Modifier None Typical Low $2,951.21 Median $10,715.19 Typical High $12,302.69 | Facility | None | $2,951.21 | $10,715.19 | $12,302.69 |
DeanCare Setting Professional Modifier None Typical Low $6,165.95 Median $10,232.93 Typical High $13,182.57 | Professional | None | $6,165.95 | $10,232.93 | $13,182.57 |
Medica Setting Facility Modifier None Typical Low $5,128.61 Median $10,715.19 Typical High $47,863.01 | Facility | None | $5,128.61 | $10,715.19 | $47,863.01 |
Medica Setting Professional Modifier None Typical Low $5,011.87 Median $7,079.46 Typical High $52,480.75 | Professional | None | $5,011.87 | $7,079.46 | $52,480.75 |
Network Health Setting Facility Modifier None Typical Low $17,378.01 Median $17,378.01 Typical High $17,378.01 | Facility | None | $17,378.01 | $17,378.01 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $7,762.47 Median $10,232.93 Typical High $19,054.61 | Professional | None | $7,762.47 | $10,232.93 | $19,054.61 |
Prevea360 Setting Facility Modifier None Typical Low $2,951.21 Median $10,715.19 Typical High $12,302.69 | Facility | None | $2,951.21 | $10,715.19 | $12,302.69 |
Prevea360 Setting Professional Modifier None Typical Low $6,165.95 Median $10,232.93 Typical High $10,715.19 | Professional | None | $6,165.95 | $10,232.93 | $10,715.19 |
Quartz Setting Professional Modifier None Typical Low $10,232.93 Median $14,791.08 Typical High $23,442.29 | Professional | None | $10,232.93 | $14,791.08 | $23,442.29 |
Quartz Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Quartz Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $7,244.36 | Professional | None | $5,248.07 | $5,248.07 | $7,244.36 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $15,135.61 | Facility | None | $4,365.16 | $5,128.61 | $15,135.61 |
United Setting Professional Modifier None Typical Low $3,801.89 Median $6,606.93 Typical High $9,332.54 | Professional | None | $3,801.89 | $6,606.93 | $9,332.54 |
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 $5,370.32 Median $5,370.32 Typical High $7,413.10 | Professional | 52 · Reduced service | $5,370.32 | $5,370.32 | $7,413.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,137.96 Median $2,137.96 Typical High $2,951.21 | Professional | 53 · Discontinued | $2,137.96 | $2,137.96 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,621.81 Median $1,621.81 Typical High $2,238.72 | Professional | 55 · Aftercare only | $1,621.81 | $1,621.81 | $2,238.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,071.52 Median $1,071.52 Typical High $1,479.11 | Professional | 56 · Pre-op care only | $1,071.52 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $562.34 Median $562.34 Typical High $1,584.89 | Professional | RR · Rental | $562.34 | $562.34 | $1,584.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,265.80 Median $4,265.80 Typical High $4,570.88 | Professional | UE · Used equipment | $4,265.80 | $4,265.80 | $4,570.88 |
Where Wisconsin sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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
$10,715
HI $11,220NJ $5,248
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.