How much rates vary
Facilitymedian $115 · 10th to 90th $91 to $269Professionalmedian $112 · 10th to 90th $56 to $174
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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $158.49 | Professional | None | $114.82 | $114.82 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $131.83 Typical High $190.55 | Facility | None | $114.82 | $131.83 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $151.36 | Professional | None | $61.66 | $114.82 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $234.42 Typical High $489.78 | Facility | None | $91.20 | $234.42 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $218.78 | Professional | None | $77.62 | $97.72 | $218.78 |
DeanCare Setting Facility Modifier None Typical Low $33.11 Median $114.82 Typical High $131.83 | Facility | None | $33.11 | $114.82 | $131.83 |
DeanCare Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $138.04 | Professional | None | $64.57 | $112.20 | $138.04 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $114.82 Typical High $537.03 | Facility | None | $56.23 | $114.82 | $537.03 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $575.44 | Professional | None | $52.48 | $75.86 | $575.44 |
Network Health Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $199.53 | Professional | None | $83.18 | $107.15 | $199.53 |
Prevea360 Setting Facility Modifier None Typical Low $33.11 Median $114.82 Typical High $131.83 | Facility | None | $33.11 | $114.82 | $131.83 |
Prevea360 Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $114.82 | Professional | None | $64.57 | $112.20 | $114.82 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $257.04 | Professional | None | $112.20 | $162.18 | $257.04 |
Quartz Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Quartz Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
United Setting Professional Modifier None Typical Low $42.66 Median $72.44 Typical High $97.72 | Professional | None | $42.66 | $72.44 | $97.72 |
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 $57.54 Median $57.54 Typical High $79.43 | Professional | 52 · Reduced service | $57.54 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $31.62 | Professional | 53 · Discontinued | $22.91 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $23.99 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $15.85 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $8.13 | Professional | RR · Rental | $6.17 | $6.17 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | UE · Used equipment | $45.71 | $45.71 | $48.98 |
Where Wisconsin sits
The same service costs 1.9 times more in Montana than in Virginia. 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
$115
MT $120VA $61.66
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.