How much rates vary
Facilitymedian $52 · 10th to 90th $32 to $112Professionalmedian $49 · 10th to 90th $26 to $78
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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $51.29 Typical High $89.13 | Professional | None | $40.74 | $51.29 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $58.88 Typical High $85.11 | Facility | None | $52.48 | $58.88 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $67.61 | Professional | None | $40.74 | $52.48 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $107.15 Typical High $218.78 | Facility | None | $34.67 | $107.15 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $97.72 | Professional | None | $25.70 | $38.90 | $97.72 |
DeanCare Setting Facility Modifier None Typical Low $14.13 Median $51.29 Typical High $58.88 | Facility | None | $14.13 | $51.29 | $58.88 |
DeanCare Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $72.44 | Professional | None | $56.23 | $69.18 | $72.44 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $51.29 Typical High $229.09 | Facility | None | $25.70 | $51.29 | $229.09 |
Medica Setting Professional Modifier None Typical Low $22.39 Median $33.88 Typical High $83.18 | Professional | None | $22.39 | $33.88 | $83.18 |
Network Health Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Network Health Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $89.13 | Professional | None | $37.15 | $47.86 | $89.13 |
Prevea360 Setting Facility Modifier None Typical Low $14.13 Median $51.29 Typical High $58.88 | Facility | None | $14.13 | $51.29 | $58.88 |
Prevea360 Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $58.88 | Professional | None | $29.51 | $51.29 | $58.88 |
Quartz Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $112.20 | Professional | None | $48.98 | $70.79 | $112.20 |
Quartz Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $34.67 | Facility | None | $30.20 | $34.67 | $34.67 |
Quartz Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Security Health Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $47.86 | Professional | None | $40.74 | $47.86 | $47.86 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $70.79 | Facility | None | $16.22 | $29.51 | $70.79 |
United Setting Professional Modifier None Typical Low $20.42 Median $31.62 Typical High $43.65 | Professional | None | $20.42 | $31.62 | $43.65 |
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 $25.70 Median $25.70 Typical High $44.67 | Professional | 52 · Reduced service | $25.70 | $25.70 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $17.78 | Professional | 53 · Discontinued | $10.23 | $10.23 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $13.49 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $8.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $3.24 Typical High $3.47 | Professional | RR · Rental | $3.24 | $3.24 | $3.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | UE · Used equipment | $24.55 | $24.55 | $25.70 |
Where Wisconsin sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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
$51.29
HI $77.62DC $24.55
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.