How much rates vary
Facilitymedian $32 · 10th to 90th $25 to $74Professionalmedian $30 · 10th to 90th $17 to $50
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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $199.53 | Professional | None | $31.62 | $31.62 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $37.15 Typical High $53.70 | Facility | None | $32.36 | $37.15 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $32.36 Typical High $39.81 | Professional | None | $25.12 | $32.36 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $66.07 Typical High $134.90 | Facility | None | $25.12 | $66.07 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $26.92 Typical High $61.66 | Professional | None | $21.38 | $26.92 | $61.66 |
DeanCare Setting Facility Modifier None Typical Low $9.12 Median $31.62 Typical High $36.31 | Facility | None | $9.12 | $31.62 | $36.31 |
DeanCare Setting Professional Modifier None Typical Low $31.62 Median $50.12 Typical High $52.48 | Professional | None | $31.62 | $50.12 | $52.48 |
Medica Setting Facility Modifier None Typical Low $15.85 Median $31.62 Typical High $134.90 | Facility | None | $15.85 | $31.62 | $134.90 |
Medica Setting Professional Modifier None Typical Low $14.79 Median $21.38 Typical High $158.49 | Professional | None | $14.79 | $21.38 | $158.49 |
Network Health Setting Professional Modifier None Typical Low $22.91 Median $29.51 Typical High $54.95 | Professional | None | $22.91 | $29.51 | $54.95 |
Prevea360 Setting Facility Modifier None Typical Low $9.12 Median $31.62 Typical High $36.31 | Facility | None | $9.12 | $31.62 | $36.31 |
Prevea360 Setting Professional Modifier None Typical Low $18.20 Median $30.90 Typical High $31.62 | Professional | None | $18.20 | $30.90 | $31.62 |
Quartz Setting Professional Modifier None Typical Low $30.90 Median $48.98 Typical High $72.44 | Professional | None | $30.90 | $48.98 | $72.44 |
Quartz Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Quartz Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
United Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
United Setting Professional Modifier None Typical Low $11.75 Median $20.42 Typical High $26.92 | Professional | None | $11.75 | $20.42 | $26.92 |
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 $15.85 Median $15.85 Typical High $100.00 | Professional | 52 · Reduced service | $15.85 | $15.85 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $39.81 | Professional | 53 · Discontinued | $6.31 | $6.31 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $30.20 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $19.95 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $2.51 Typical High $4.79 | Professional | RR · Rental | $2.51 | $2.51 | $4.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | UE · Used equipment | $16.98 | $18.62 | $18.62 |
Where Wisconsin sits
The same service costs 2.1 times more in Minnesota 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· 5th of 51
$31.62
MN $37.15DC $17.38
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.