How much rates vary
Facilitymedian $54 · 10th to 90th $39 to $132Professionalmedian $45 · 10th to 90th $20 to $81
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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $33.88 Typical High $112.20 | Professional | None | $20.42 | $33.88 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $53.70 Typical High $79.43 | Facility | None | $48.98 | $53.70 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | None | $44.67 | $44.67 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $151.36 Typical High $223.87 | Facility | None | $131.83 | $151.36 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $38.90 Typical High $81.28 | Professional | None | $19.95 | $38.90 | $81.28 |
DeanCare Setting Facility Modifier None Typical Low $27.54 Median $47.86 Typical High $50.12 | Facility | None | $27.54 | $47.86 | $50.12 |
DeanCare Setting Professional Modifier None Typical Low $43.65 Median $117.49 Typical High $134.90 | Professional | None | $43.65 | $117.49 | $134.90 |
Medica Setting Facility Modifier None Typical Low $27.54 Median $47.86 Typical High $95.50 | Facility | None | $27.54 | $47.86 | $95.50 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $31.62 Typical High $316.23 | Professional | None | $21.88 | $31.62 | $316.23 |
Network Health Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $117.49 | Professional | None | $44.67 | $63.10 | $117.49 |
Prevea360 Setting Facility Modifier None Typical Low $27.54 Median $47.86 Typical High $50.12 | Facility | None | $27.54 | $47.86 | $50.12 |
Prevea360 Setting Professional Modifier None Typical Low $26.30 Median $47.86 Typical High $47.86 | Professional | None | $26.30 | $47.86 | $47.86 |
Quartz Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $107.15 | Professional | None | $46.77 | $72.44 | $107.15 |
Quartz Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Security Health Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
The Alliance Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $104.71 | Professional | None | $53.70 | $79.43 | $104.71 |
United Setting Professional Modifier None Typical Low $15.85 Median $23.44 Typical High $43.65 | Professional | None | $15.85 | $23.44 | $43.65 |
5 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 $16.98 Median $16.98 Typical High $56.23 | Professional | 52 · Reduced service | $16.98 | $16.98 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $22.39 | Professional | 53 · Discontinued | $6.92 | $6.92 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $25.70 Typical High $85.11 | Professional | 54 · Surgery only | $25.70 | $25.70 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $16.98 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $11.22 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $11.22 |
Where Wisconsin sits
The same service costs 2.8 times more in Hawaii 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· 10th of 51
$44.67
HI $51.29NY $18.62
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.