How much rates vary
Facilitymedian $93 · 10th to 90th $71 to $234Professionalmedian $71 · 10th to 90th $39 to $120
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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | None | $69.18 | $70.79 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $141.25 | Facility | None | $85.11 | $93.33 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | None | $79.43 | $79.43 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $263.03 Typical High $398.11 | Facility | None | $234.42 | $263.03 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $85.11 Typical High $120.23 | Professional | None | $39.81 | $85.11 | $120.23 |
DeanCare Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $87.10 | Facility | None | $67.61 | $83.18 | $87.10 |
DeanCare Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $154.88 | Professional | None | $131.83 | $154.88 | $154.88 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $128.82 | Facility | None | $67.61 | $83.18 | $128.82 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $501.19 | Professional | None | $38.02 | $41.69 | $501.19 |
Network Health Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $120.23 | Professional | None | $63.10 | $79.43 | $120.23 |
Prevea360 Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $87.10 | Facility | None | $67.61 | $83.18 | $87.10 |
Quartz Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $204.17 | Professional | None | $81.28 | $97.72 | $204.17 |
Quartz Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Security Health Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
The Alliance Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $199.53 | Professional | None | $104.71 | $120.23 | $199.53 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $15.14 Median $39.81 Typical High $63.10 | Professional | None | $15.14 | $39.81 | $63.10 |
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 $34.67 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $34.67 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $13.80 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.47 Typical High $10.72 | Professional | 55 · Aftercare only | $10.23 | $10.47 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.92 | $7.08 | $7.08 |
Where Wisconsin sits
The same service costs 2.7 times more in Hawaii 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· 13th of 51
$70.79
HI $107OH $39.81
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.