How much rates vary
Facilitymedian $71 · 10th to 90th $54 to $174Professionalmedian $52 · 10th to 90th $30 to $91
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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $52.48 | Professional | None | $51.29 | $52.48 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $70.79 Typical High $104.71 | Facility | None | $64.57 | $70.79 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | None | $60.26 | $60.26 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $199.53 Typical High $295.12 | Facility | None | $173.78 | $199.53 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $72.44 Typical High $91.20 | Professional | None | $30.20 | $72.44 | $91.20 |
DeanCare Setting Facility Modifier None Typical Low $51.29 Median $63.10 Typical High $66.07 | Facility | None | $51.29 | $63.10 | $66.07 |
DeanCare Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $117.49 | Professional | None | $107.15 | $109.65 | $117.49 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $63.10 Typical High $97.72 | Facility | None | $51.29 | $63.10 | $97.72 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $31.62 Typical High $398.11 | Professional | None | $28.18 | $31.62 | $398.11 |
Network Health Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Network Health Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $91.20 | Professional | None | $46.77 | $60.26 | $91.20 |
Prevea360 Setting Facility Modifier None Typical Low $51.29 Median $63.10 Typical High $66.07 | Facility | None | $51.29 | $63.10 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $154.88 | Professional | None | $61.66 | $72.44 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Security Health Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
The Alliance Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $154.88 | Professional | None | $79.43 | $91.20 | $154.88 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $12.88 Median $30.90 Typical High $46.77 | Professional | None | $12.88 | $30.90 | $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 $25.70 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $25.70 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.23 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.59 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.13 | $5.25 | $5.25 |
Where Wisconsin sits
The same service costs 2.8 times more in Montana than in Ohio. 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· 17th of 51
$53.70
MT $83.18OH $30.20
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.