How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.62 | Professional | None | $4.90 | $4.90 | $5.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.31 Median $19.50 Typical High $19.50 | Professional | None | $6.31 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $109.65 Typical High $165.96 | Facility | None | $97.72 | $109.65 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $50.12 | Professional | None | $40.74 | $40.74 | $50.12 |
DeanCare Setting Facility Modifier None Typical Low $5.13 Median $5.75 Typical High $10.72 | Facility | None | $5.13 | $5.75 | $10.72 |
DeanCare Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Medica Setting Facility Modifier None Typical Low $5.13 Median $6.17 Typical High $75.86 | Facility | None | $5.13 | $6.17 | $75.86 |
Medica Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $125.89 | Professional | None | $23.99 | $23.99 | $125.89 |
Prevea360 Setting Facility Modifier None Typical Low $5.13 Median $5.75 Typical High $10.72 | Facility | None | $5.13 | $5.75 | $10.72 |
Quartz Setting Professional Modifier None Typical Low $5.89 Median $7.08 Typical High $11.75 | Professional | None | $5.89 | $7.08 | $11.75 |
Quartz Setting Professional Modifier None Typical Low $6.92 Median $19.05 Typical High $25.70 | Professional | None | $6.92 | $19.05 | $25.70 |
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 $20.89 Median $23.99 Typical High $23.99 | Professional | None | $20.89 | $23.99 | $23.99 |
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 $2.45 Median $2.45 Typical High $2.63 | Professional | 52 · Reduced service | $2.45 | $2.45 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $0.98 Typical High $1.07 | Professional | 53 · Discontinued | $0.98 | $0.98 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $0.76 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.49 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.49 | $0.49 | $0.50 |
Where Wisconsin sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 41st of 51
$19.50
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.