How much rates vary
Facilitymedian $48 · 10th to 90th $35 to $120Professionalmedian $41 · 10th to 90th $18 to $72
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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $107.15 | Professional | None | $26.30 | $30.90 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $47.86 Typical High $72.44 | Facility | None | $43.65 | $47.86 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | None | $40.74 | $40.74 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $134.90 Typical High $204.17 | Facility | None | $120.23 | $134.90 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $34.67 Typical High $72.44 | Professional | None | $17.78 | $34.67 | $72.44 |
DeanCare Setting Facility Modifier None Typical Low $24.55 Median $42.66 Typical High $44.67 | Facility | None | $24.55 | $42.66 | $44.67 |
DeanCare Setting Professional Modifier None Typical Low $38.90 Median $147.91 Typical High $169.82 | Professional | None | $38.90 | $147.91 | $169.82 |
Medica Setting Facility Modifier None Typical Low $24.55 Median $42.66 Typical High $87.10 | Facility | None | $24.55 | $42.66 | $87.10 |
Medica Setting Professional Modifier None Typical Low $19.50 Median $28.18 Typical High $416.87 | Professional | None | $19.50 | $28.18 | $416.87 |
Network Health Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $107.15 | Professional | None | $39.81 | $56.23 | $107.15 |
Prevea360 Setting Facility Modifier None Typical Low $24.55 Median $42.66 Typical High $44.67 | Facility | None | $24.55 | $42.66 | $44.67 |
Prevea360 Setting Professional Modifier None Typical Low $34.67 Median $42.66 Typical High $42.66 | Professional | None | $34.67 | $42.66 | $42.66 |
Quartz Setting Professional Modifier None Typical Low $41.69 Median $64.57 Typical High $95.50 | Professional | None | $41.69 | $64.57 | $95.50 |
Quartz Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Security Health Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
The Alliance Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $112.20 | Professional | None | $47.86 | $72.44 | $112.20 |
United Setting Professional Modifier None Typical Low $14.13 Median $21.38 Typical High $39.81 | Professional | None | $14.13 | $21.38 | $39.81 |
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 $15.49 Median $15.49 Typical High $53.70 | Professional | 52 · Reduced service | $15.49 | $15.49 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $21.38 | Professional | 53 · Discontinued | $6.17 | $6.17 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $22.91 Typical High $81.28 | Professional | 54 · Surgery only | $22.91 | $22.91 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $16.22 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $10.72 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $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· 9th of 51
$40.74
HI $46.77NY $16.98
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.