How much rates vary
Facilitymedian $107 · 10th to 90th $55 to $148Professionalmedian $56 · 10th to 90th $52 to $105
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 $54.95 Median $54.95 Typical High $123.03 | Facility | None | $54.95 | $54.95 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $251.19 | Professional | None | $54.95 | $54.95 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $107.15 Typical High $117.49 | Facility | None | $97.72 | $107.15 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $72.44 | Professional | None | $52.48 | $58.88 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $128.82 Typical High $147.91 | Facility | None | $74.13 | $128.82 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $104.71 | Professional | None | $47.86 | $67.61 | $104.71 |
DeanCare Setting Facility Modifier None Typical Low $47.86 Median $56.23 Typical High $117.49 | Facility | None | $47.86 | $56.23 | $117.49 |
DeanCare Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $120.23 Typical High $158.49 | Facility | None | $52.48 | $120.23 | $158.49 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
Network Health Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Prevea360 Setting Facility Modifier None Typical Low $47.86 Median $56.23 Typical High $117.49 | Facility | None | $47.86 | $56.23 | $117.49 |
Prevea360 Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Quartz Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $138.04 | Professional | None | $52.48 | $85.11 | $138.04 |
Quartz Setting Facility Modifier None Typical Low $63.10 Median $144.54 Typical High $144.54 | Facility | None | $63.10 | $144.54 | $144.54 |
Quartz Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Security Health Setting Professional Modifier None Typical Low $56.23 Median $72.44 Typical High $89.13 | Professional | None | $56.23 | $72.44 | $89.13 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
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 $27.54 Median $27.54 Typical High $125.89 | Professional | 52 · Reduced service | $27.54 | $27.54 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $50.12 | Professional | 53 · Discontinued | $10.96 | $10.96 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $38.02 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $25.12 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $25.12 |
Where Wisconsin sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 11th of 51
$61.66
AZ $83.18RI $47.86
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.