How much rates vary
Facilitymedian $19,953 · 10th to 90th $12,589 to $42,658Professionalmedian $18,621 · 10th to 90th $9,120 to $29,512
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 $19,498.45 Median $19,498.45 Typical High $19,498.45 | Facility | None | $19,498.45 | $19,498.45 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $19,498.45 Median $19,498.45 Typical High $29,512.09 | Professional | None | $19,498.45 | $19,498.45 | $29,512.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $19,952.62 Median $22,387.21 Typical High $32,359.37 | Facility | None | $19,952.62 | $22,387.21 | $32,359.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,715.19 Median $19,952.62 Typical High $24,547.09 | Professional | None | $10,715.19 | $19,952.62 | $24,547.09 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $39,810.72 Typical High $83,176.38 | Facility | None | $12,589.25 | $39,810.72 | $83,176.38 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $13,489.63 Typical High $37,153.52 | Professional | None | $9,120.11 | $13,489.63 | $37,153.52 |
DeanCare Setting Facility Modifier None Typical Low $5,623.41 Median $19,498.45 Typical High $22,387.21 | Facility | None | $5,623.41 | $19,498.45 | $22,387.21 |
DeanCare Setting Professional Modifier None Typical Low $11,220.18 Median $19,054.61 Typical High $23,442.29 | Professional | None | $11,220.18 | $19,054.61 | $23,442.29 |
Medica Setting Facility Modifier None Typical Low $9,772.37 Median $19,498.45 Typical High $91,201.08 | Facility | None | $9,772.37 | $19,498.45 | $91,201.08 |
Medica Setting Professional Modifier None Typical Low $9,120.11 Median $13,182.57 Typical High $114,815.36 | Professional | None | $9,120.11 | $13,182.57 | $114,815.36 |
Network Health Setting Facility Modifier None Typical Low $31,622.78 Median $31,622.78 Typical High $31,622.78 | Facility | None | $31,622.78 | $31,622.78 | $31,622.78 |
Network Health Setting Professional Modifier None Typical Low $14,125.38 Median $18,197.01 Typical High $33,884.42 | Professional | None | $14,125.38 | $18,197.01 | $33,884.42 |
Prevea360 Setting Facility Modifier None Typical Low $5,623.41 Median $19,498.45 Typical High $22,387.21 | Facility | None | $5,623.41 | $19,498.45 | $22,387.21 |
Prevea360 Setting Professional Modifier None Typical Low $11,220.18 Median $19,054.61 Typical High $19,498.45 | Professional | None | $11,220.18 | $19,054.61 | $19,498.45 |
Quartz Setting Professional Modifier None Typical Low $19,498.45 Median $28,183.83 Typical High $44,668.36 | Professional | None | $19,498.45 | $28,183.83 | $44,668.36 |
Quartz Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $13,182.57 | Facility | None | $12,589.25 | $12,589.25 | $13,182.57 |
Quartz Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $12,589.25 | Professional | None | $9,120.11 | $9,120.11 | $12,589.25 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $9,332.54 Typical High $28,840.32 | Facility | None | $7,943.28 | $9,332.54 | $28,840.32 |
United Setting Professional Modifier None Typical Low $7,244.36 Median $12,589.25 Typical High $16,982.44 | Professional | None | $7,244.36 | $12,589.25 | $16,982.44 |
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 $9,772.37 Median $9,772.37 Typical High $14,791.08 | Professional | 52 · Reduced service | $9,772.37 | $9,772.37 | $14,791.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,890.45 Median $3,890.45 Typical High $5,888.44 | Professional | 53 · Discontinued | $3,890.45 | $3,890.45 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,884.03 Median $2,884.03 Typical High $4,466.84 | Professional | 55 · Aftercare only | $2,884.03 | $2,884.03 | $4,466.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,949.84 Median $1,949.84 Typical High $2,951.21 | Professional | 56 · Pre-op care only | $1,949.84 | $1,949.84 | $2,951.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,071.52 Median $1,071.52 Typical High $1,380.38 | Professional | RR · Rental | $1,071.52 | $1,071.52 | $1,380.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,943.28 Median $7,943.28 Typical High $8,709.64 | Professional | UE · Used equipment | $7,943.28 | $7,943.28 | $8,709.64 |
Where Wisconsin sits
The same service costs 2.5 times more in Montana than in Florida. 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
$19,498
MT $22,387FL $9,120
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.