How much rates vary
Facilitymedian $550 · 10th to 90th $251 to $1,514Professionalmedian $537 · 10th to 90th $200 to $832
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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $870.96 | Professional | None | $537.03 | $537.03 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $602.56 Typical High $912.01 | Facility | None | $549.54 | $602.56 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $741.31 | Professional | None | $512.86 | $549.54 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $1,513.56 Typical High $2,290.87 | Facility | None | $251.19 | $1,513.56 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $389.05 Typical High $1,047.13 | Professional | None | $199.53 | $389.05 | $1,047.13 |
DeanCare Setting Facility Modifier None Typical Low $128.82 Median $537.03 Typical High $616.60 | Facility | None | $128.82 | $537.03 | $616.60 |
DeanCare Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $660.69 | Professional | None | $309.03 | $489.78 | $660.69 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $537.03 Typical High $2,089.30 | Facility | None | $223.87 | $537.03 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $2,630.27 | Professional | None | $245.47 | $309.03 | $2,630.27 |
Network Health Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $933.25 | Professional | None | $389.05 | $501.19 | $933.25 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $537.03 Typical High $616.60 | Facility | None | $128.82 | $537.03 | $616.60 |
Prevea360 Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $537.03 | Professional | None | $309.03 | $407.38 | $537.03 |
Quartz Setting Professional Modifier None Typical Low $446.68 Median $724.44 Typical High $1,023.29 | Professional | None | $446.68 | $724.44 | $1,023.29 |
Quartz Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $269.15 | Facility | None | $251.19 | $251.19 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $467.74 | Professional | None | $177.83 | $302.00 | $467.74 |
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 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $436.52 | Professional | 52 · Reduced service | $269.15 | $269.15 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $173.78 | Professional | 53 · Discontinued | $107.15 | $107.15 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $131.83 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $87.10 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $87.10 |
Where Wisconsin sits
The same service costs 3.4 times more in Montana than in New York. 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· 2nd of 51
$537
MT $562NY $166
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.