How much rates vary
Facilitymedian $26 · 10th to 90th $19 to $65Professionalmedian $22 · 10th to 90th $10 to $40
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 $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $16.98 Typical High $70.79 | Professional | None | $13.80 | $16.98 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.99 Median $26.30 Typical High $38.90 | Facility | None | $23.99 | $26.30 | $38.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $26.92 | Professional | None | $21.88 | $21.88 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $74.13 Typical High $109.65 | Facility | None | $64.57 | $74.13 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $19.05 Typical High $39.81 | Professional | None | $9.77 | $19.05 | $39.81 |
DeanCare Setting Facility Modifier None Typical Low $13.49 Median $23.44 Typical High $24.55 | Facility | None | $13.49 | $23.44 | $24.55 |
DeanCare Setting Professional Modifier None Typical Low $21.38 Median $87.10 Typical High $100.00 | Professional | None | $21.38 | $87.10 | $100.00 |
Medica Setting Facility Modifier None Typical Low $13.49 Median $23.44 Typical High $47.86 | Facility | None | $13.49 | $23.44 | $47.86 |
Medica Setting Professional Modifier None Typical Low $10.72 Median $15.49 Typical High $269.15 | Professional | None | $10.72 | $15.49 | $269.15 |
Network Health Setting Professional Modifier None Typical Low $21.88 Median $30.90 Typical High $58.88 | Professional | None | $21.88 | $30.90 | $58.88 |
Prevea360 Setting Facility Modifier None Typical Low $13.49 Median $23.44 Typical High $24.55 | Facility | None | $13.49 | $23.44 | $24.55 |
Prevea360 Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $23.44 | Professional | None | $22.39 | $23.44 | $23.44 |
Quartz Setting Professional Modifier None Typical Low $22.39 Median $35.48 Typical High $51.29 | Professional | None | $22.39 | $35.48 | $51.29 |
Quartz Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Security Health 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 $15.14 Median $17.78 Typical High $19.50 | Professional | None | $15.14 | $17.78 | $19.50 |
The Alliance Setting Professional Modifier None Typical Low $26.30 Median $38.90 Typical High $72.44 | Professional | None | $26.30 | $38.90 | $72.44 |
United Setting Professional Modifier None Typical Low $7.76 Median $11.75 Typical High $21.38 | Professional | None | $7.76 | $11.75 | $21.38 |
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 $8.32 Median $8.32 Typical High $36.31 | Professional | 52 · Reduced service | $8.32 | $8.32 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $14.45 | Professional | 53 · Discontinued | $3.39 | $3.39 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $12.59 Typical High $53.70 | Professional | 54 · Surgery only | $12.59 | $12.59 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $10.72 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $7.24 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $7.24 |
Where Wisconsin sits
The same service costs 2.9 times more in Rhode Island 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· 11th of 51
$21.88
RI $26.92NY $9.33
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.