How much rates vary
Facilitymedian $18,621 · 10th to 90th $11,749 to $39,811Professionalmedian $17,378 · 10th to 90th $8,511 to $27,542
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 $18,197.01 Median $18,197.01 Typical High $18,197.01 | Facility | None | $18,197.01 | $18,197.01 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $26,915.35 | Professional | None | $18,197.01 | $18,197.01 | $26,915.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $18,620.87 Median $20,892.96 Typical High $30,199.52 | Facility | None | $18,620.87 | $20,892.96 | $30,199.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,232.93 Median $18,620.87 Typical High $22,908.68 | Professional | None | $10,232.93 | $18,620.87 | $22,908.68 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $37,153.52 Typical High $77,624.71 | Facility | None | $11,748.98 | $37,153.52 | $77,624.71 |
Cigna Setting Professional Modifier None Typical Low $8,511.38 Median $12,882.50 Typical High $34,673.69 | Professional | None | $8,511.38 | $12,882.50 | $34,673.69 |
DeanCare Setting Facility Modifier None Typical Low $5,495.41 Median $18,197.01 Typical High $20,892.96 | Facility | None | $5,495.41 | $18,197.01 | $20,892.96 |
DeanCare Setting Professional Modifier None Typical Low $10,471.29 Median $17,782.79 Typical High $21,877.62 | Professional | None | $10,471.29 | $17,782.79 | $21,877.62 |
Medica Setting Facility Modifier None Typical Low $9,120.11 Median $18,197.01 Typical High $87,096.36 | Facility | None | $9,120.11 | $18,197.01 | $87,096.36 |
Medica Setting Professional Modifier None Typical Low $8,511.38 Median $12,882.50 Typical High $112,201.85 | Professional | None | $8,511.38 | $12,882.50 | $112,201.85 |
Network Health Setting Facility Modifier None Typical Low $29,512.09 Median $29,512.09 Typical High $29,512.09 | Facility | None | $29,512.09 | $29,512.09 | $29,512.09 |
Network Health Setting Professional Modifier None Typical Low $13,182.57 Median $16,982.44 Typical High $31,622.78 | Professional | None | $13,182.57 | $16,982.44 | $31,622.78 |
Prevea360 Setting Facility Modifier None Typical Low $5,495.41 Median $18,197.01 Typical High $20,892.96 | Facility | None | $5,495.41 | $18,197.01 | $20,892.96 |
Prevea360 Setting Professional Modifier None Typical Low $10,471.29 Median $17,782.79 Typical High $18,197.01 | Professional | None | $10,471.29 | $17,782.79 | $18,197.01 |
Quartz Setting Professional Modifier None Typical Low $18,620.87 Median $26,915.35 Typical High $42,657.95 | Professional | None | $18,620.87 | $26,915.35 | $42,657.95 |
Quartz Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,302.69 | Facility | None | $11,748.98 | $11,748.98 | $12,302.69 |
Quartz Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $11,748.98 | Professional | None | $8,511.38 | $8,511.38 | $11,748.98 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $8,912.51 Typical High $27,542.29 | Facility | None | $7,585.78 | $8,912.51 | $27,542.29 |
United Setting Professional Modifier None Typical Low $7,079.46 Median $12,022.64 Typical High $16,218.10 | Professional | None | $7,079.46 | $12,022.64 | $16,218.10 |
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 $9,120.11 Median $9,120.11 Typical High $13,489.63 | Professional | 52 · Reduced service | $9,120.11 | $9,120.11 | $13,489.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,630.78 Median $3,630.78 Typical High $5,370.32 | Professional | 53 · Discontinued | $3,630.78 | $3,630.78 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,691.53 Median $2,691.53 Typical High $4,073.80 | Professional | 55 · Aftercare only | $2,691.53 | $2,691.53 | $4,073.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,819.70 Median $1,819.70 Typical High $2,691.53 | Professional | 56 · Pre-op care only | $1,819.70 | $1,819.70 | $2,691.53 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,023.29 Median $1,023.29 Typical High $2,884.03 | Professional | RR · Rental | $1,023.29 | $1,023.29 | $2,884.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,762.47 Median $7,762.47 Typical High $8,317.64 | Professional | UE · Used equipment | $7,762.47 | $7,762.47 | $8,317.64 |
Where Wisconsin sits
The same service costs 2.6 times more in Montana 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· 6th of 51
$18,197
MT $21,878NJ $8,511
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.