How much rates vary
Facilitymedian $78 · 10th to 90th $44 to $170Professionalmedian $76 · 10th to 90th $37 to $117
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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $158.49 | Professional | None | $75.86 | $75.86 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $89.13 Typical High $128.82 | Facility | None | $77.62 | $89.13 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $77.62 Typical High $97.72 | Professional | None | $42.66 | $77.62 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $158.49 Typical High $323.59 | Facility | None | $43.65 | $158.49 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $147.91 | Professional | None | $37.15 | $46.77 | $147.91 |
DeanCare Setting Facility Modifier None Typical Low $21.88 Median $75.86 Typical High $87.10 | Facility | None | $21.88 | $75.86 | $87.10 |
DeanCare Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $109.65 | Professional | None | $75.86 | $104.71 | $109.65 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $75.86 Typical High $354.81 | Facility | None | $38.02 | $75.86 | $354.81 |
Medica Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $380.19 | Professional | None | $35.48 | $51.29 | $380.19 |
Network Health Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Network Health Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $134.90 | Professional | None | $54.95 | $72.44 | $134.90 |
Prevea360 Setting Facility Modifier None Typical Low $21.88 Median $75.86 Typical High $87.10 | Facility | None | $21.88 | $75.86 | $87.10 |
Prevea360 Setting Professional Modifier None Typical Low $43.65 Median $74.13 Typical High $75.86 | Professional | None | $43.65 | $74.13 | $75.86 |
Quartz Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $173.78 | Professional | None | $75.86 | $109.65 | $173.78 |
Quartz Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Quartz Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $28.18 Median $48.98 Typical High $66.07 | Professional | None | $28.18 | $48.98 | $66.07 |
4 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 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $23.44 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $15.85 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $5.37 | Professional | RR · Rental | $4.27 | $4.27 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | UE · Used equipment | $31.62 | $31.62 | $34.67 |
Where Wisconsin sits
The same service costs 2.2 times more in Montana than in West 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· 6th of 51
$75.86
MT $81.28WV $37.15
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.