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 $151.36 Median $1,905.46 Typical High $14,454.40 | Facility | None | $151.36 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $1,698.24 | Professional | None | $151.36 | $151.36 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $616.60 Typical High $812.83 | Professional | None | $281.84 | $616.60 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $2,691.53 | Facility | None | $645.65 | $954.99 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $549.54 | Professional | None | $302.00 | $331.13 | $549.54 |
DeanCare Setting Facility Modifier None Typical Low $208.93 Median $3,311.31 Typical High $6,025.60 | Facility | None | $208.93 | $3,311.31 | $6,025.60 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $954.99 Typical High $1,778.28 | Facility | None | $204.17 | $954.99 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $549.54 Typical High $1,000.00 | Professional | None | $213.80 | $549.54 | $1,000.00 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $1,621.81 Typical High $2,344.23 | Facility | None | $831.76 | $1,621.81 | $2,344.23 |
Prevea360 Setting Facility Modifier None Typical Low $151.36 Median $194.98 Typical High $354.81 | Facility | None | $151.36 | $194.98 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $213.80 Median $446.68 Typical High $660.69 | Professional | None | $213.80 | $446.68 | $660.69 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $2,691.53 | Facility | None | $645.65 | $954.99 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $562.34 | Professional | None | $331.13 | $331.13 | $562.34 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $199.53 Median $501.19 Typical High $954.99 | Professional | None | $199.53 | $501.19 | $954.99 |
5 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 $75.86 Median $75.86 Typical High $831.76 | Professional | 52 · Reduced service | $75.86 | $75.86 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $338.84 | Professional | 53 · Discontinued | $30.20 | $30.20 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $1,258.93 | Professional | 54 · Surgery only | $112.20 | $112.20 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $251.19 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $169.82 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $169.82 |
Where Wisconsin sits
The same service costs 7.2 times more in Oklahoma than in Virginia. 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· 3rd of 51
$575
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.