How much rates vary
Facilitymedian $58 · 10th to 90th $43 to $145Professionalmedian $49 · 10th to 90th $21 to $87
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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $37.15 Typical High $120.23 | Professional | None | $34.67 | $37.15 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $57.54 Typical High $87.10 | Facility | None | $52.48 | $57.54 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $58.88 | Professional | None | $48.98 | $48.98 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $162.18 Typical High $245.47 | Facility | None | $144.54 | $162.18 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $41.69 Typical High $87.10 | Professional | None | $21.38 | $41.69 | $87.10 |
DeanCare Setting Facility Modifier None Typical Low $30.20 Median $51.29 Typical High $53.70 | Facility | None | $30.20 | $51.29 | $53.70 |
DeanCare Setting Professional Modifier None Typical Low $46.77 Median $186.21 Typical High $213.80 | Professional | None | $46.77 | $186.21 | $213.80 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $51.29 Typical High $104.71 | Facility | None | $30.20 | $51.29 | $104.71 |
Medica Setting Professional Modifier None Typical Low $23.99 Median $33.88 Typical High $724.44 | Professional | None | $23.99 | $33.88 | $724.44 |
Network Health Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $128.82 | Professional | None | $47.86 | $67.61 | $128.82 |
Prevea360 Setting Facility Modifier None Typical Low $30.20 Median $51.29 Typical High $53.70 | Facility | None | $30.20 | $51.29 | $53.70 |
Prevea360 Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $60.26 | Professional | None | $51.29 | $51.29 | $60.26 |
Quartz Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $114.82 | Professional | None | $50.12 | $79.43 | $114.82 |
Quartz Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Security Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | None | $102.33 | $102.33 | $120.23 |
The Alliance Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $194.98 | Professional | None | $58.88 | $87.10 | $194.98 |
United Setting Professional Modifier None Typical Low $16.98 Median $25.70 Typical High $47.86 | Professional | None | $16.98 | $25.70 | $47.86 |
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 $18.62 Median $18.62 Typical High $58.88 | Professional | 52 · Reduced service | $18.62 | $18.62 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $23.99 | Professional | 53 · Discontinued | $7.41 | $7.41 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $27.54 Typical High $89.13 | Professional | 54 · Surgery only | $27.54 | $27.54 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $17.78 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $12.02 |
Where Wisconsin sits
The same service costs 2.6 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
$48.98
HI $54.95NY $20.89
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.