How much rates vary
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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $489.78 | Professional | None | $416.87 | $489.78 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $645.65 Typical High $977.24 | Facility | None | $588.84 | $645.65 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $588.84 | Professional | None | $549.54 | $549.54 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,754.23 | Facility | None | $1,621.81 | $1,819.70 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $426.58 Typical High $831.76 | Professional | None | $218.78 | $426.58 | $831.76 |
DeanCare Setting Facility Modifier None Typical Low $478.63 Median $575.44 Typical High $602.56 | Facility | None | $478.63 | $575.44 | $602.56 |
DeanCare Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,047.13 | Professional | None | $524.81 | $891.25 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $575.44 Typical High $707.95 | Facility | None | $478.63 | $575.44 | $707.95 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $2,951.21 | Professional | None | $223.87 | $295.12 | $2,951.21 |
Network Health Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $831.76 | Professional | None | $436.52 | $549.54 | $831.76 |
Prevea360 Setting Facility Modifier None Typical Low $478.63 Median $575.44 Typical High $602.56 | Facility | None | $478.63 | $575.44 | $602.56 |
Quartz Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $1,122.02 | Professional | None | $446.68 | $588.84 | $1,122.02 |
Quartz Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Security Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
United Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $457.09 | Professional | None | $186.21 | $275.42 | $457.09 |
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 $208.93 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $63.10 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $41.69 | $48.98 | $48.98 |
Where Wisconsin sits
The same service costs 2.8 times more in Montana than in Florida. 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· 12th of 51
$490
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.