How much rates vary
Facilitymedian $200 · 10th to 90th $151 to $437Professionalmedian $162 · 10th to 90th $126 to $631
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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $338.84 | Professional | None | $154.88 | $158.49 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $891.25 | Professional | None | $144.54 | $245.47 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $389.05 Typical High $512.86 | Facility | None | $199.53 | $389.05 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $263.03 | Professional | None | $125.89 | $125.89 | $263.03 |
DeanCare Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $331.13 | Facility | None | $147.91 | $151.36 | $331.13 |
DeanCare Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $338.84 | Facility | None | $147.91 | $151.36 | $338.84 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $691.83 | Professional | None | $151.36 | $151.36 | $691.83 |
Network Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Network Health Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $204.17 | Professional | None | $165.96 | $177.83 | $204.17 |
Prevea360 Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $331.13 | Facility | None | $147.91 | $151.36 | $331.13 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $380.19 | Professional | None | $141.25 | $194.98 | $380.19 |
Quartz Setting Facility Modifier None Typical Low $169.82 Median $389.05 Typical High $389.05 | Facility | None | $169.82 | $389.05 | $389.05 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Security Health Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $251.19 | Professional | None | $169.82 | $204.17 | $251.19 |
The Alliance Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
4 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 $79.43 Median $79.43 Typical High $169.82 | Professional | 52 · Reduced service | $79.43 | $79.43 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $67.61 | Professional | 53 · Discontinued | $31.62 | $31.62 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $51.29 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $33.88 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $33.88 |
Where Wisconsin sits
The same service costs 2.9 times more in Wyoming than in North Carolina. 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· 7th of 51
$166
WY $339NC $117
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.