How much rates vary
Facilitymedian $240 · 10th to 90th $107 to $457Professionalmedian $151 · 10th to 90th $138 to $501
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 $154.88 Median $154.88 Typical High $309.03 | Facility | None | $154.88 | $154.88 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $154.88 Typical High $724.44 | Professional | None | $151.36 | $154.88 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $269.15 Typical High $302.00 | Facility | None | $251.19 | $269.15 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $190.55 | Professional | None | $147.91 | $147.91 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $162.18 | Professional | None | $107.15 | $107.15 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $245.47 Typical High $457.09 | Facility | None | $109.65 | $245.47 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $218.78 | Professional | None | $147.91 | $147.91 | $218.78 |
DeanCare Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $234.42 | Facility | None | $107.15 | $107.15 | $234.42 |
DeanCare Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $676.08 | Facility | None | $134.90 | $134.90 | $676.08 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $1,348.96 | Professional | None | $134.90 | $162.18 | $1,348.96 |
Network Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $144.54 | Facility | None | $128.82 | $128.82 | $144.54 |
Network Health Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $158.49 | Professional | None | $141.25 | $158.49 | $158.49 |
Prevea360 Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $234.42 | Facility | None | $107.15 | $107.15 | $234.42 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $309.03 | Professional | None | $141.25 | $218.78 | $309.03 |
Quartz Setting Facility Modifier None Typical Low $245.47 Median $457.09 Typical High $457.09 | Facility | None | $245.47 | $457.09 | $457.09 |
Quartz Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Security Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $245.47 | Professional | None | $199.53 | $199.53 | $245.47 |
The Alliance Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $309.03 | Professional | None | $138.04 | $263.03 | $309.03 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $177.83 | Professional | None | $134.90 | $147.91 | $177.83 |
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 $75.86 Median $77.62 Typical High $363.08 | Professional | 52 · Reduced service | $75.86 | $77.62 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.90 Typical High $144.54 | Professional | 53 · Discontinued | $30.20 | $30.90 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.91 Typical High $109.65 | Professional | 55 · Aftercare only | $22.39 | $22.91 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.49 Typical High $72.44 | Professional | 56 · Pre-op care only | $15.14 | $15.49 | $72.44 |
Where Wisconsin sits
The same service costs 2.4 times more in Wyoming 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· 18th of 51
$151
WY $355NY $148
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.