How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $275.42 | Professional | None | $181.97 | $181.97 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $91.20 Typical High $138.04 | Professional | 52 · Reduced service | $91.20 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $56.23 | Professional | 53 · Discontinued | $37.15 | $37.15 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $41.69 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $14.45 Typical High $21.38 | Facility | None | $12.59 | $14.45 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $363.08 | Professional | None | $229.09 | $229.09 | $363.08 |
DeanCare Setting Facility Modifier None Typical Low $97.72 Median $181.97 Typical High $331.13 | Facility | None | $97.72 | $181.97 | $331.13 |
DeanCare Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | None | $120.23 | $141.25 | $141.25 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $181.97 Typical High $275.42 | Facility | None | $89.13 | $181.97 | $275.42 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Prevea360 Setting Facility Modifier None Typical Low $97.72 Median $181.97 Typical High $331.13 | Facility | None | $97.72 | $181.97 | $331.13 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $186.21 | Professional | None | $72.44 | $107.15 | $186.21 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
2 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $5.75 | $5.75 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $42.66 | $42.66 | $42.66 |
Where Wisconsin sits
The same service costs 26.3 times more in Rhode Island than in South Carolina. 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· 14th of 51
$182
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.