How much rates vary
Facilitymedian $93 · 10th to 90th $69 to $234Professionalmedian $79 · 10th to 90th $35 to $141
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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $173.78 | Professional | None | $51.29 | $60.26 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $141.25 | Facility | None | $85.11 | $93.33 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | None | $79.43 | $79.43 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $263.03 Typical High $398.11 | Facility | None | $234.42 | $263.03 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $67.61 Typical High $141.25 | Professional | None | $34.67 | $67.61 | $141.25 |
DeanCare Setting Facility Modifier None Typical Low $48.98 Median $83.18 Typical High $87.10 | Facility | None | $48.98 | $83.18 | $87.10 |
DeanCare Setting Professional Modifier None Typical Low $75.86 Median $169.82 Typical High $194.98 | Professional | None | $75.86 | $169.82 | $194.98 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $83.18 Typical High $169.82 | Facility | None | $48.98 | $83.18 | $169.82 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $56.23 Typical High $549.54 | Professional | None | $38.90 | $56.23 | $549.54 |
Network Health Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $208.93 | Professional | None | $79.43 | $112.20 | $208.93 |
Prevea360 Setting Facility Modifier None Typical Low $48.98 Median $83.18 Typical High $87.10 | Facility | None | $48.98 | $83.18 | $87.10 |
Prevea360 Setting Professional Modifier None Typical Low $44.67 Median $83.18 Typical High $83.18 | Professional | None | $44.67 | $83.18 | $83.18 |
Quartz Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $186.21 | Professional | None | $81.28 | $128.82 | $186.21 |
Quartz Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Security Health Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | None | $75.86 | $75.86 | $89.13 |
United Setting Professional Modifier None Typical Low $27.54 Median $41.69 Typical High $77.62 | Professional | None | $27.54 | $41.69 | $77.62 |
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 $30.20 Median $30.20 Typical High $87.10 | Professional | 52 · Reduced service | $30.20 | $30.20 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $34.67 | Professional | 53 · Discontinued | $12.02 | $12.02 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $45.71 Typical High $131.83 | Professional | 54 · Surgery only | $45.71 | $45.71 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $26.30 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $17.38 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $17.38 |
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· 9th of 51
$79.43
HI $91.20NY $33.11
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.