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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $389.05 | Professional | None | $77.62 | $77.62 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $186.21 Typical High $295.12 | Professional | None | $81.28 | $186.21 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
DeanCare Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $173.78 | Facility | None | $74.13 | $93.33 | $173.78 |
Medica Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $19,054.61 | Facility | None | $1,698.24 | $4,570.88 | $19,054.61 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $218.78 Typical High $512.86 | Professional | None | $104.71 | $218.78 | $512.86 |
Prevea360 Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $173.78 | Facility | None | $74.13 | $93.33 | $173.78 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $269.15 | Professional | None | $112.20 | $190.55 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $7,244.36 Typical High $19,498.45 | Facility | None | $2,511.89 | $7,244.36 | $19,498.45 |
United Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $316.23 | Professional | None | $87.10 | $147.91 | $316.23 |
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 $38.90 Median $38.90 Typical High $194.98 | Professional | 52 · Reduced service | $38.90 | $38.90 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $77.62 | Professional | 53 · Discontinued | $15.49 | $15.49 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $57.54 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $38.90 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $38.90 |
Where Wisconsin sits
The same service costs 12.6 times more in California 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· 7th of 51
$155
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.