How much rates vary
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 $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,786.30 | Professional | None | $3,630.78 | $3,630.78 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $4,265.80 Typical High $6,165.95 | Facility | None | $3,715.35 | $4,265.80 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $3,715.35 Typical High $4,677.35 | Professional | None | $2,089.30 | $3,715.35 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $7,585.78 Typical High $15,848.93 | Facility | None | $2,398.83 | $7,585.78 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $7,079.46 | Professional | None | $1,737.80 | $2,570.40 | $7,079.46 |
DeanCare Setting Facility Modifier None Typical Low $1,096.48 Median $3,630.78 Typical High $4,265.80 | Facility | None | $1,096.48 | $3,630.78 | $4,265.80 |
DeanCare Setting Professional Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $4,466.84 | Professional | None | $2,089.30 | $3,388.44 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $1,862.09 Median $3,630.78 Typical High $16,982.44 | Facility | None | $1,862.09 | $3,630.78 | $16,982.44 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $22,387.21 | Professional | None | $1,698.24 | $2,570.40 | $22,387.21 |
Network Health Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Facility | None | $5,888.44 | $5,888.44 | $5,888.44 |
Network Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,467.37 Typical High $6,456.54 | Professional | None | $2,630.27 | $3,467.37 | $6,456.54 |
Prevea360 Setting Facility Modifier None Typical Low $1,096.48 Median $3,630.78 Typical High $4,265.80 | Facility | None | $1,096.48 | $3,630.78 | $4,265.80 |
Prevea360 Setting Professional Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $3,630.78 | Professional | None | $2,089.30 | $3,388.44 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $3,715.35 Median $5,370.32 Typical High $8,511.38 | Professional | None | $3,715.35 | $5,370.32 | $8,511.38 |
Quartz Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,454.71 | Facility | None | $2,398.83 | $2,398.83 | $2,454.71 |
Quartz Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,737.80 | $1,737.80 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $5,495.41 | Facility | None | $1,445.44 | $1,698.24 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,162.28 | Professional | None | $1,412.54 | $2,398.83 | $3,162.28 |
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 $1,819.70 Median $1,819.70 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,819.70 | $1,819.70 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $741.31 Typical High $954.99 | Professional | 53 · Discontinued | $741.31 | $741.31 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $549.54 Typical High $724.44 | Professional | 55 · Aftercare only | $549.54 | $549.54 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $363.08 Typical High $478.63 | Professional | 56 · Pre-op care only | $363.08 | $363.08 | $478.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | RR · Rental | $208.93 | $208.93 | $257.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,548.82 Median $1,548.82 Typical High $1,659.59 | Professional | UE · Used equipment | $1,548.82 | $1,548.82 | $1,659.59 |
Where Wisconsin sits
The same service costs 2.2 times more in Arkansas 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· 3rd of 51
$3,631
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.