How much rates vary
Facilitymedian $52 · 10th to 90th $33 to $98Professionalmedian $35 · 10th to 90th $32 to $145
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 $33.11 Median $33.11 Typical High $81.28 | Facility | None | $33.11 | $33.11 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $33.11 Typical High $165.96 | Professional | None | $31.62 | $33.11 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $70.79 Typical High $79.43 | Facility | None | $66.07 | $70.79 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $40.74 | Professional | None | $31.62 | $31.62 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $60.26 Typical High $104.71 | Facility | None | $48.98 | $60.26 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $60.26 | Professional | None | $31.62 | $31.62 | $60.26 |
DeanCare Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $89.13 | Facility | None | $40.74 | $40.74 | $89.13 |
DeanCare Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $97.72 | Facility | None | $44.67 | $44.67 | $97.72 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $234.42 | Professional | None | $44.67 | $52.48 | $234.42 |
Network Health Setting Facility Modifier None Typical Low $44.67 Median $46.77 Typical High $46.77 | Facility | None | $44.67 | $46.77 | $46.77 |
Network Health Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | None | $54.95 | $61.66 | $61.66 |
Prevea360 Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $89.13 | Facility | None | $40.74 | $40.74 | $89.13 |
Quartz Setting Professional Modifier None Typical Low $31.62 Median $57.54 Typical High $102.33 | Professional | None | $31.62 | $57.54 | $102.33 |
Quartz Setting Facility Modifier None Typical Low $52.48 Median $97.72 Typical High $97.72 | Facility | None | $52.48 | $97.72 | $97.72 |
Quartz Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Security Health Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $52.48 | Professional | None | $42.66 | $43.65 | $52.48 |
United Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $46.77 | Professional | None | $35.48 | $39.81 | $46.77 |
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 $16.22 Median $16.60 Typical High $83.18 | Professional | 52 · Reduced service | $16.22 | $16.60 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.61 Typical High $33.11 | Professional | 53 · Discontinued | $6.46 | $6.61 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.90 Typical High $25.12 | Professional | 55 · Aftercare only | $4.79 | $4.90 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.31 Typical High $16.60 | Professional | 56 · Pre-op care only | $3.24 | $3.31 | $16.60 |
Where Wisconsin sits
The same service costs 1.7 times more in Hawaii than in Kentucky. 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· 13th of 51
$37.15
HI $54.95KY $31.62
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.