How much rates vary
Facilitymedian $10,471 · 10th to 90th $5,623 to $28,840Professionalmedian $10,233 · 10th to 90th $4,786 to $15,849
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 $10,232.93 Median $10,232.93 Typical High $10,232.93 | Facility | None | $10,232.93 | $10,232.93 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $14,454.40 | Professional | None | $10,232.93 | $10,232.93 | $14,454.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,471.29 Median $11,481.54 Typical High $17,378.01 | Facility | None | $10,471.29 | $11,481.54 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $9,772.37 Median $10,471.29 Typical High $14,125.38 | Professional | None | $9,772.37 | $10,471.29 | $14,125.38 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $28,840.32 Typical High $44,668.36 | Facility | None | $5,623.41 | $28,840.32 | $44,668.36 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $6,025.60 Typical High $19,952.62 | Professional | None | $4,786.30 | $6,025.60 | $19,952.62 |
DeanCare Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $12,022.64 | Facility | None | $5,248.07 | $10,232.93 | $12,022.64 |
DeanCare Setting Professional Modifier None Typical Low $10,232.93 Median $11,220.18 Typical High $12,589.25 | Professional | None | $10,232.93 | $11,220.18 | $12,589.25 |
Medica Setting Facility Modifier None Typical Low $6,606.93 Median $10,232.93 Typical High $44,668.36 | Facility | None | $6,606.93 | $10,232.93 | $44,668.36 |
Medica Setting Professional Modifier None Typical Low $4,897.79 Median $7,079.46 Typical High $51,286.14 | Professional | None | $4,897.79 | $7,079.46 | $51,286.14 |
Network Health Setting Professional Modifier None Typical Low $9,120.11 Median $12,882.50 Typical High $25,703.96 | Professional | None | $9,120.11 | $12,882.50 | $25,703.96 |
Prevea360 Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $12,022.64 | Facility | None | $5,248.07 | $10,232.93 | $12,022.64 |
Prevea360 Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | None | $10,232.93 | $10,232.93 | $10,232.93 |
Quartz Setting Professional Modifier None Typical Low $10,000.00 Median $14,454.40 Typical High $22,908.68 | Professional | None | $10,000.00 | $14,454.40 | $22,908.68 |
Quartz Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Quartz Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $3,801.89 Median $6,918.31 Typical High $9,120.11 | Professional | None | $3,801.89 | $6,918.31 | $9,120.11 |
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 $5,128.61 Median $5,128.61 Typical High $7,244.36 | Professional | 52 · Reduced service | $5,128.61 | $5,128.61 | $7,244.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,089.30 Median $2,089.30 Typical High $2,884.03 | Professional | 53 · Discontinued | $2,089.30 | $2,089.30 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,548.82 Median $1,548.82 Typical High $2,187.76 | Professional | 55 · Aftercare only | $1,548.82 | $1,548.82 | $2,187.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,023.29 Median $1,023.29 Typical High $1,445.44 | Professional | 56 · Pre-op care only | $1,023.29 | $1,023.29 | $1,445.44 |
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· 2nd of 51
$10,233
MT $10,715NY $4,169
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.