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 $4.17 Median $4.17 Typical High $4.79 | Facility | None | $4.17 | $4.17 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $4.17 Typical High $46.77 | Professional | None | $3.02 | $4.17 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.41 Median $9.12 Typical High $9.55 | Facility | None | $7.41 | $9.12 | $9.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.09 Median $5.75 Typical High $16.98 | Professional | None | $2.09 | $5.75 | $16.98 |
CareSource Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
CareSource Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $10.47 Typical High $13.80 | Facility | None | $8.91 | $10.47 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $9.12 Typical High $12.30 | Professional | None | $2.69 | $9.12 | $12.30 |
DeanCare Setting Facility Modifier None Typical Low $2.29 Median $12.59 Typical High $19.95 | Facility | None | $2.29 | $12.59 | $19.95 |
Medica Setting Facility Modifier None Typical Low $2.29 Median $3.47 Typical High $100.00 | Facility | None | $2.29 | $3.47 | $100.00 |
Medica Setting Professional Modifier None Typical Low $2.09 Median $3.47 Typical High $9.33 | Professional | None | $2.09 | $3.47 | $9.33 |
Network Health Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $7.24 | Facility | None | $3.98 | $3.98 | $7.24 |
Network Health Setting Professional Modifier None Typical Low $2.63 Median $3.55 Typical High $9.77 | Professional | None | $2.63 | $3.55 | $9.77 |
Prevea360 Setting Facility Modifier None Typical Low $2.29 Median $2.82 Typical High $4.47 | Facility | None | $2.29 | $2.82 | $4.47 |
Quartz Setting Professional Modifier None Typical Low $3.72 Median $7.94 Typical High $11.75 | Professional | None | $3.72 | $7.94 | $11.75 |
Quartz Setting Professional Modifier None Typical Low $1.62 Median $2.69 Typical High $18.62 | Professional | None | $1.62 | $2.69 | $18.62 |
Security Health Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.41 | Professional | None | $7.24 | $7.24 | $7.41 |
Security Health Setting Professional Modifier None Typical Low $7.24 Median $19.05 Typical High $24.55 | Professional | None | $7.24 | $19.05 | $24.55 |
United Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Facility | None | $4.17 | $4.17 | $4.17 |
United Setting Professional Modifier None Typical Low $2.04 Median $3.47 Typical High $10.72 | Professional | None | $2.04 | $3.47 | $10.72 |
2 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 $2.09 Median $2.09 Typical High $23.44 | Professional | 52 · Reduced service | $2.09 | $2.09 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $9.33 | Professional | 53 · Discontinued | $0.83 | $0.83 | $9.33 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska 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· 4th of 51
$5.13
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.