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 $6.61 Median $6.92 Typical High $8.91 | Facility | None | $6.61 | $6.92 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $6.92 Typical High $144.54 | Professional | None | $6.76 | $6.92 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.30 Median $15.14 Typical High $15.85 | Facility | None | $12.30 | $15.14 | $15.85 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $11.75 Typical High $41.69 | Professional | None | $2.88 | $11.75 | $41.69 |
CareSource Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
CareSource Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $16.98 Typical High $22.39 | Facility | None | $14.45 | $16.98 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $10.00 Typical High $18.20 | Professional | None | $3.80 | $10.00 | $18.20 |
DeanCare Setting Facility Modifier None Typical Low $4.57 Median $28.84 Typical High $44.67 | Facility | None | $4.57 | $28.84 | $44.67 |
Medica Setting Facility Modifier None Typical Low $4.57 Median $57.54 Typical High $100.00 | Facility | None | $4.57 | $57.54 | $100.00 |
Medica Setting Professional Modifier None Typical Low $3.47 Median $5.75 Typical High $19.05 | Professional | None | $3.47 | $5.75 | $19.05 |
Network Health Setting Facility Modifier None Typical Low $6.92 Median $8.91 Typical High $16.60 | Facility | None | $6.92 | $8.91 | $16.60 |
Network Health Setting Professional Modifier None Typical Low $4.37 Median $5.89 Typical High $16.22 | Professional | None | $4.37 | $5.89 | $16.22 |
Prevea360 Setting Facility Modifier None Typical Low $4.57 Median $5.01 Typical High $7.41 | Facility | None | $4.57 | $5.01 | $7.41 |
Quartz Setting Professional Modifier None Typical Low $6.31 Median $13.49 Typical High $23.99 | Professional | None | $6.31 | $13.49 | $23.99 |
Quartz Setting Professional Modifier None Typical Low $2.82 Median $3.80 Typical High $15.14 | Professional | None | $2.82 | $3.80 | $15.14 |
Security Health Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $23.99 | Professional | None | $12.30 | $12.30 | $23.99 |
Security Health Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $40.74 | Professional | None | $23.99 | $26.92 | $40.74 |
United Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Facility | None | $6.92 | $6.92 | $6.92 |
United Setting Professional Modifier None Typical Low $2.88 Median $5.01 Typical High $21.88 | Professional | None | $2.88 | $5.01 | $21.88 |
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 $3.47 Median $3.47 Typical High $72.44 | Professional | 52 · Reduced service | $3.47 | $3.47 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.38 Typical High $28.84 | Professional | 53 · Discontinued | $1.38 | $1.38 | $28.84 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $3.98 Median $5.75 Typical High $8.51 | Professional | QW · Waived lab test | $3.98 | $5.75 | $8.51 |
Where Wisconsin sits
The same service costs 12.9 times more in Vermont than in Alabama. 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· 11th of 51
$10.00
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.