How much rates vary
Facilitymedian $10,965 · 10th to 90th $7,586 to $23,988Professionalmedian $10,233 · 10th to 90th $5,495 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 $7,943.28 Median $10,715.19 Typical High $16,982.44 | Professional | None | $7,943.28 | $10,715.19 | $16,982.44 |
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 $6,606.93 Median $10,964.78 Typical High $13,489.63 | Professional | None | $6,606.93 | $10,964.78 | $13,489.63 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $22,387.21 Typical High $45,708.82 | Facility | None | $7,585.78 | $22,387.21 | $45,708.82 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $8,317.64 Typical High $20,892.96 | Professional | None | $5,495.41 | $8,317.64 | $20,892.96 |
DeanCare Setting Facility Modifier None Typical Low $3,019.95 Median $10,715.19 Typical High $12,302.69 | Facility | None | $3,019.95 | $10,715.19 | $12,302.69 |
DeanCare Setting Professional Modifier None Typical Low $10,715.19 Median $13,803.84 Typical High $14,454.40 | Professional | None | $10,715.19 | $13,803.84 | $14,454.40 |
Medica Setting Facility Modifier None Typical Low $5,248.07 Median $10,715.19 Typical High $48,977.88 | Facility | None | $5,248.07 | $10,715.19 | $48,977.88 |
Medica Setting Professional Modifier None Typical Low $5,011.87 Median $7,079.46 Typical High $54,954.09 | Professional | None | $5,011.87 | $7,079.46 | $54,954.09 |
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 $10,000.00 Typical High $18,620.87 | Professional | None | $7,762.47 | $10,000.00 | $18,620.87 |
Prevea360 Setting Facility Modifier None Typical Low $3,019.95 Median $10,715.19 Typical High $12,302.69 | Facility | None | $3,019.95 | $10,715.19 | $12,302.69 |
Prevea360 Setting Professional Modifier None Typical Low $6,165.95 Median $9,772.37 Typical High $10,715.19 | Professional | None | $6,165.95 | $9,772.37 | $10,715.19 |
Quartz Setting Professional Modifier None Typical Low $10,471.29 Median $15,135.61 Typical High $23,988.33 | Professional | None | $10,471.29 | $15,135.61 | $23,988.33 |
Quartz Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
Quartz Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,495.41 | $7,585.78 |
Security Health Setting Professional Modifier None Typical Low $7,585.78 Median $8,912.51 Typical High $8,912.51 | Professional | None | $7,585.78 | $8,912.51 | $8,912.51 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $15,488.17 | Facility | None | $4,265.80 | $4,786.30 | $15,488.17 |
United Setting Professional Modifier None Typical Low $3,890.45 Median $6,760.83 Typical High $9,120.11 | Professional | None | $3,890.45 | $6,760.83 | $9,120.11 |
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 $5,370.32 Median $5,370.32 Typical High $9,120.11 | Professional | 52 · Reduced service | $5,370.32 | $5,370.32 | $9,120.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,137.96 Median $2,137.96 Typical High $3,630.78 | Professional | 53 · Discontinued | $2,137.96 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,621.81 Median $1,621.81 Typical High $2,691.53 | Professional | 55 · Aftercare only | $1,621.81 | $1,621.81 | $2,691.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,071.52 Median $1,071.52 Typical High $1,819.70 | Professional | 56 · Pre-op care only | $1,071.52 | $1,071.52 | $1,819.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | RR · Rental | $660.69 | $660.69 | $758.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,897.79 Median $4,897.79 Typical High $5,248.07 | Professional | UE · Used equipment | $4,897.79 | $4,897.79 | $5,248.07 |
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· 6th of 51
$10,471
MT $11,220PA $5,370
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.