How much rates vary
Facilitymedian $89 · 10th to 90th $69 to $195Professionalmedian $87 · 10th to 90th $44 to $135
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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $102.33 Typical High $147.91 | Facility | None | $89.13 | $102.33 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $117.49 | Professional | None | $48.98 | $89.13 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $181.97 Typical High $371.54 | Facility | None | $69.18 | $181.97 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $169.82 | Professional | None | $58.88 | $74.13 | $169.82 |
DeanCare Setting Facility Modifier None Typical Low $25.12 Median $87.10 Typical High $100.00 | Facility | None | $25.12 | $87.10 | $100.00 |
DeanCare Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $107.15 | Professional | None | $50.12 | $85.11 | $107.15 |
Medica Setting Facility Modifier None Typical Low $43.65 Median $87.10 Typical High $407.38 | Facility | None | $43.65 | $87.10 | $407.38 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $446.68 | Professional | None | $40.74 | $58.88 | $446.68 |
Network Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Network Health Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $154.88 | Professional | None | $63.10 | $83.18 | $154.88 |
Prevea360 Setting Facility Modifier None Typical Low $25.12 Median $87.10 Typical High $100.00 | Facility | None | $25.12 | $87.10 | $100.00 |
Prevea360 Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $87.10 | Professional | None | $50.12 | $85.11 | $87.10 |
Quartz Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $199.53 | Professional | None | $87.10 | $125.89 | $199.53 |
Quartz Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Quartz Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $32.36 Median $56.23 Typical High $75.86 | Professional | None | $32.36 | $56.23 | $75.86 |
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 $43.65 Median $43.65 Typical High $58.88 | Professional | 52 · Reduced service | $43.65 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $23.99 | Professional | 53 · Discontinued | $17.38 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $17.78 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $12.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $6.17 | Professional | RR · Rental | $4.79 | $4.79 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $35.48 Typical High $46.77 | Professional | UE · Used equipment | $35.48 | $35.48 | $46.77 |
Where Wisconsin sits
The same service costs 2.0 times more in Montana 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· 7th of 51
$87.10
MT $93.33SC $46.77
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.