How much rates vary
Facilitymedian $47 · 10th to 90th $35 to $117Professionalmedian $40 · 10th to 90th $17 to $71
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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $107.15 | Professional | None | $25.12 | $30.20 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $46.77 Typical High $70.79 | Facility | None | $42.66 | $46.77 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $47.86 | Professional | None | $39.81 | $39.81 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $131.83 Typical High $199.53 | Facility | None | $117.49 | $131.83 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $33.88 Typical High $70.79 | Professional | None | $17.38 | $33.88 | $70.79 |
DeanCare Setting Facility Modifier None Typical Low $24.55 Median $41.69 Typical High $43.65 | Facility | None | $24.55 | $41.69 | $43.65 |
DeanCare Setting Professional Modifier None Typical Low $38.02 Median $104.71 Typical High $120.23 | Professional | None | $38.02 | $104.71 | $120.23 |
Medica Setting Facility Modifier None Typical Low $24.55 Median $41.69 Typical High $85.11 | Facility | None | $24.55 | $41.69 | $85.11 |
Medica Setting Professional Modifier None Typical Low $19.50 Median $27.54 Typical High $269.15 | Professional | None | $19.50 | $27.54 | $269.15 |
Network Health Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $104.71 | Professional | None | $39.81 | $56.23 | $104.71 |
Prevea360 Setting Facility Modifier None Typical Low $24.55 Median $41.69 Typical High $43.65 | Facility | None | $24.55 | $41.69 | $43.65 |
Prevea360 Setting Professional Modifier None Typical Low $22.39 Median $41.69 Typical High $41.69 | Professional | None | $22.39 | $41.69 | $41.69 |
Quartz Setting Professional Modifier None Typical Low $40.74 Median $64.57 Typical High $93.33 | Professional | None | $40.74 | $64.57 | $93.33 |
Quartz Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
The Alliance Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
United Setting Professional Modifier None Typical Low $13.80 Median $20.89 Typical High $38.90 | Professional | None | $13.80 | $20.89 | $38.90 |
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 $15.14 Median $15.14 Typical High $52.48 | Professional | 52 · Reduced service | $15.14 | $15.14 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $21.38 | Professional | 53 · Discontinued | $6.03 | $6.03 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.39 Typical High $79.43 | Professional | 54 · Surgery only | $22.39 | $22.39 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $15.85 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $10.72 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $10.72 |
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· 8th of 51
$39.81
HI $45.71NY $16.60
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.