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 $8.32 Median $8.32 Typical High $10.96 | Facility | None | $8.32 | $8.32 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $117.49 | Professional | None | $8.32 | $8.32 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $18.20 Typical High $19.50 | Facility | None | $15.14 | $18.20 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $14.13 Typical High $51.29 | Professional | None | $5.25 | $14.13 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
CareSource Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $20.89 Typical High $27.54 | Facility | None | $18.20 | $20.89 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $12.30 Typical High $21.88 | Professional | None | $4.57 | $12.30 | $21.88 |
DeanCare Setting Facility Modifier None Typical Low $5.62 Median $34.67 Typical High $53.70 | Facility | None | $5.62 | $34.67 | $53.70 |
Medica Setting Facility Modifier None Typical Low $5.62 Median $21.38 Typical High $120.23 | Facility | None | $5.62 | $21.38 | $120.23 |
Medica Setting Professional Modifier None Typical Low $4.17 Median $7.08 Typical High $22.91 | Professional | None | $4.17 | $7.08 | $22.91 |
Network Health Setting Facility Modifier None Typical Low $8.32 Median $10.72 Typical High $19.95 | Facility | None | $8.32 | $10.72 | $19.95 |
Network Health Setting Professional Modifier None Typical Low $5.25 Median $7.08 Typical High $19.95 | Professional | None | $5.25 | $7.08 | $19.95 |
Prevea360 Setting Facility Modifier None Typical Low $5.62 Median $6.03 Typical High $8.91 | Facility | None | $5.62 | $6.03 | $8.91 |
Quartz Setting Professional Modifier None Typical Low $7.76 Median $16.60 Typical High $29.51 | Professional | None | $7.76 | $16.60 | $29.51 |
Quartz Setting Professional Modifier None Typical Low $3.39 Median $4.57 Typical High $18.20 | Professional | None | $3.39 | $4.57 | $18.20 |
Security Health Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $14.79 | Professional | None | $10.23 | $10.23 | $14.79 |
Security Health Setting Professional Modifier None Typical Low $10.23 Median $38.02 Typical High $48.98 | Professional | None | $10.23 | $38.02 | $48.98 |
United Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
United Setting Professional Modifier None Typical Low $3.55 Median $6.17 Typical High $26.92 | Professional | None | $3.55 | $6.17 | $26.92 |
3 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 $4.17 Median $4.17 Typical High $58.88 | Professional | 52 · Reduced service | $4.17 | $4.17 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $23.44 | Professional | 53 · Discontinued | $1.70 | $1.70 | $23.44 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $4.79 Median $7.08 Typical High $10.23 | Professional | QW · Waived lab test | $4.79 | $7.08 | $10.23 |
Where Wisconsin sits
The same service costs 9.3 times more in Vermont than in New Jersey. 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· 9th of 51
$10.23
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.