How much rates vary
Facilitymedian $380 · 10th to 90th $302 to $1,047Professionalmedian $372 · 10th to 90th $186 to $589
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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $1,174.90 | Professional | None | $371.54 | $371.54 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $416.87 Typical High $630.96 | Facility | None | $380.19 | $416.87 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $512.86 | Professional | None | $354.81 | $380.19 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $1,047.13 Typical High $1,621.81 | Facility | None | $302.00 | $1,047.13 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $724.44 | Professional | None | $257.04 | $323.59 | $724.44 |
DeanCare Setting Facility Modifier None Typical Low $109.65 Median $371.54 Typical High $436.52 | Facility | None | $109.65 | $371.54 | $436.52 |
DeanCare Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $457.09 | Professional | None | $213.80 | $371.54 | $457.09 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $371.54 Typical High $1,621.81 | Facility | None | $190.55 | $371.54 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $1,995.26 | Professional | None | $173.78 | $257.04 | $1,995.26 |
Network Health Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $660.69 | Professional | None | $269.15 | $354.81 | $660.69 |
Prevea360 Setting Facility Modifier None Typical Low $109.65 Median $371.54 Typical High $436.52 | Facility | None | $109.65 | $371.54 | $436.52 |
Prevea360 Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $416.87 | Professional | None | $213.80 | $371.54 | $416.87 |
Quartz Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $870.96 | Professional | None | $380.19 | $575.44 | $870.96 |
Quartz Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Quartz Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Security Health Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | None | $302.00 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $323.59 | Professional | None | $141.25 | $251.19 | $323.59 |
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 $186.21 Median $186.21 Typical High $588.84 | Professional | 52 · Reduced service | $186.21 | $186.21 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $234.42 | Professional | 53 · Discontinued | $75.86 | $75.86 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $177.83 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $117.49 |
Where Wisconsin sits
The same service costs 3.0 times more in Iowa 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· 3rd of 51
$372
IA $457NY $151
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.