How much rates vary
Facilitymedian $676 · 10th to 90th $372 to $1,862Professionalmedian $661 · 10th to 90th $316 to $1,023
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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $954.99 | Professional | None | $660.69 | $660.69 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $741.31 Typical High $1,122.02 | Facility | None | $676.08 | $741.31 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $912.01 | Professional | None | $630.96 | $676.08 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $1,862.09 Typical High $2,884.03 | Facility | None | $371.54 | $1,862.09 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $1,288.25 | Professional | None | $316.23 | $398.11 | $1,288.25 |
DeanCare Setting Facility Modifier None Typical Low $194.98 Median $660.69 Typical High $776.25 | Facility | None | $194.98 | $660.69 | $776.25 |
DeanCare Setting Professional Modifier None Typical Low $380.19 Median $660.69 Typical High $812.83 | Professional | None | $380.19 | $660.69 | $812.83 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $660.69 Typical High $2,884.03 | Facility | None | $338.84 | $660.69 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $3,311.31 | Professional | None | $309.03 | $457.09 | $3,311.31 |
Network Health Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,174.90 | Professional | None | $478.63 | $630.96 | $1,174.90 |
Prevea360 Setting Facility Modifier None Typical Low $194.98 Median $660.69 Typical High $776.25 | Facility | None | $194.98 | $660.69 | $776.25 |
Prevea360 Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $660.69 | Professional | None | $380.19 | $380.19 | $660.69 |
Quartz Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,513.56 | Professional | None | $660.69 | $954.99 | $1,513.56 |
Quartz Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Quartz Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $575.44 | Professional | None | $251.19 | $426.58 | $575.44 |
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 $331.13 Median $331.13 Typical High $478.63 | Professional | 52 · Reduced service | $331.13 | $331.13 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $190.55 | Professional | 53 · Discontinued | $134.90 | $134.90 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $144.54 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $95.50 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $95.50 |
Where Wisconsin sits
The same service costs 2.6 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· 3rd of 51
$661
MT $708NY $275
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.