How much rates vary
Facilitymedian $129 · 10th to 90th $58 to $282Professionalmedian $62 · 10th to 90th $58 to $195
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 $57.54 Median $57.54 Typical High $128.82 | Facility | None | $57.54 | $57.54 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $165.96 | Professional | None | $57.54 | $57.54 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $194.98 | Professional | None | $57.54 | $60.26 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $251.19 Typical High $331.13 | Facility | None | $95.50 | $251.19 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $109.65 | Professional | None | $61.66 | $61.66 | $109.65 |
DeanCare Setting Facility Modifier None Typical Low $56.23 Median $102.33 Typical High $123.03 | Facility | None | $56.23 | $102.33 | $123.03 |
DeanCare Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $147.91 | Professional | None | $63.10 | $138.04 | $147.91 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $102.33 Typical High $123.03 | Facility | None | $56.23 | $102.33 | $123.03 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $478.63 | Professional | None | $60.26 | $77.62 | $478.63 |
Network Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Network Health Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $85.11 | Professional | None | $69.18 | $69.18 | $85.11 |
Prevea360 Setting Facility Modifier None Typical Low $56.23 Median $102.33 Typical High $123.03 | Facility | None | $56.23 | $102.33 | $123.03 |
Prevea360 Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Quartz Setting Professional Modifier None Typical Low $63.10 Median $107.15 Typical High $154.88 | Professional | None | $63.10 | $107.15 | $154.88 |
Quartz Setting Facility Modifier None Typical Low $81.28 Median $186.21 Typical High $186.21 | Facility | None | $81.28 | $186.21 | $186.21 |
Quartz Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Security Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $154.88 | Professional | None | $83.18 | $83.18 | $154.88 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | None | $60.26 | $60.26 | $79.43 |
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 $28.84 Median $28.84 Typical High $83.18 | Professional | 52 · Reduced service | $28.84 | $28.84 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $33.11 | Professional | 53 · Discontinued | $11.48 | $11.48 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $24.55 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $16.60 |
Where Wisconsin sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 34th of 51
$61.66
AK $91.20HI $56.23
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.