How much rates vary
Facilitymedian $14,454 · 10th to 90th $9,120 to $30,903Professionalmedian $13,183 · 10th to 90th $6,607 to $21,380
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 $14,125.38 Median $14,125.38 Typical High $14,125.38 | Facility | None | $14,125.38 | $14,125.38 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $21,379.62 | Professional | None | $14,125.38 | $14,125.38 | $21,379.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $14,454.40 Median $16,218.10 Typical High $23,442.29 | Facility | None | $14,454.40 | $16,218.10 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $7,413.10 Median $14,454.40 Typical High $17,782.79 | Professional | None | $7,413.10 | $14,454.40 | $17,782.79 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $28,840.32 Typical High $60,255.96 | Facility | None | $9,120.11 | $28,840.32 | $60,255.96 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $9,772.37 Typical High $26,915.35 | Professional | None | $6,606.93 | $9,772.37 | $26,915.35 |
DeanCare Setting Facility Modifier None Typical Low $3,981.07 Median $14,125.38 Typical High $16,218.10 | Facility | None | $3,981.07 | $14,125.38 | $16,218.10 |
DeanCare Setting Professional Modifier None Typical Low $7,943.28 Median $12,882.50 Typical High $16,982.44 | Professional | None | $7,943.28 | $12,882.50 | $16,982.44 |
Medica Setting Facility Modifier None Typical Low $6,760.83 Median $14,125.38 Typical High $63,095.73 | Facility | None | $6,760.83 | $14,125.38 | $63,095.73 |
Medica Setting Professional Modifier None Typical Low $6,456.54 Median $9,332.54 Typical High $81,283.05 | Professional | None | $6,456.54 | $9,332.54 | $81,283.05 |
Network Health Setting Facility Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $22,387.21 | Facility | None | $22,387.21 | $22,387.21 | $22,387.21 |
Network Health Setting Professional Modifier None Typical Low $10,232.93 Median $13,182.57 Typical High $24,547.09 | Professional | None | $10,232.93 | $13,182.57 | $24,547.09 |
Prevea360 Setting Facility Modifier None Typical Low $3,981.07 Median $14,125.38 Typical High $16,218.10 | Facility | None | $3,981.07 | $14,125.38 | $16,218.10 |
Prevea360 Setting Professional Modifier None Typical Low $7,943.28 Median $12,302.69 Typical High $14,125.38 | Professional | None | $7,943.28 | $12,302.69 | $14,125.38 |
Quartz Setting Professional Modifier None Typical Low $13,489.63 Median $19,498.45 Typical High $30,902.95 | Professional | None | $13,489.63 | $19,498.45 | $30,902.95 |
Quartz Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,332.54 | Facility | None | $9,120.11 | $9,120.11 | $9,332.54 |
Quartz Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $9,120.11 | Professional | None | $6,606.93 | $6,606.93 | $9,120.11 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $6,165.95 Typical High $19,952.62 | Facility | None | $5,128.61 | $6,165.95 | $19,952.62 |
United Setting Professional Modifier None Typical Low $5,128.61 Median $8,709.64 Typical High $12,302.69 | Professional | None | $5,128.61 | $8,709.64 | $12,302.69 |
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 $7,079.46 Median $7,079.46 Typical High $10,715.19 | Professional | 52 · Reduced service | $7,079.46 | $7,079.46 | $10,715.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,818.38 Median $2,818.38 Typical High $4,265.80 | Professional | 53 · Discontinued | $2,818.38 | $2,818.38 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,089.30 Median $2,089.30 Typical High $3,162.28 | Professional | 55 · Aftercare only | $2,089.30 | $2,089.30 | $3,162.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,412.54 Median $1,412.54 Typical High $2,137.96 | Professional | 56 · Pre-op care only | $1,412.54 | $1,412.54 | $2,137.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $741.31 Median $741.31 Typical High $2,041.74 | Professional | RR · Rental | $741.31 | $741.31 | $2,041.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5,623.41 Median $5,623.41 Typical High $6,025.60 | Professional | UE · Used equipment | $5,623.41 | $5,623.41 | $6,025.60 |
Where Wisconsin sits
The same service costs 2.5 times more in Montana than in Delaware. 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
$14,125
MT $16,596DE $6,607
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.