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 $4.68 Median $4.68 Typical High $6.03 | Facility | None | $4.68 | $4.68 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $4.68 Typical High $67.61 | Professional | None | $4.57 | $4.68 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.51 Median $10.23 Typical High $10.72 | Facility | None | $8.51 | $10.23 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $7.94 Typical High $21.88 | Professional | None | $1.95 | $7.94 | $21.88 |
CareSource Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Facility | None | $2.69 | $2.69 | $2.69 |
CareSource Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $11.48 Typical High $15.14 | Facility | None | $10.00 | $11.48 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $10.23 Typical High $19.05 | Professional | None | $2.95 | $10.23 | $19.05 |
DeanCare Setting Facility Modifier None Typical Low $3.47 Median $19.50 Typical High $30.20 | Facility | None | $3.47 | $19.50 | $30.20 |
Medica Setting Facility Modifier None Typical Low $3.72 Median $35.48 Typical High $64.57 | Facility | None | $3.72 | $35.48 | $64.57 |
Medica Setting Professional Modifier None Typical Low $2.34 Median $4.68 Typical High $12.88 | Professional | None | $2.34 | $4.68 | $12.88 |
Network Health Setting Facility Modifier None Typical Low $4.68 Median $6.03 Typical High $11.22 | Facility | None | $4.68 | $6.03 | $11.22 |
Network Health Setting Professional Modifier None Typical Low $2.95 Median $3.98 Typical High $11.22 | Professional | None | $2.95 | $3.98 | $11.22 |
Prevea360 Setting Facility Modifier None Typical Low $3.16 Median $3.55 Typical High $5.01 | Facility | None | $3.16 | $3.55 | $5.01 |
Quartz Setting Professional Modifier None Typical Low $4.47 Median $9.55 Typical High $15.49 | Professional | None | $4.47 | $9.55 | $15.49 |
Quartz Setting Professional Modifier None Typical Low $2.63 Median $2.95 Typical High $46.77 | Professional | None | $2.63 | $2.95 | $46.77 |
Security Health Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $8.32 | Professional | None | $6.03 | $6.03 | $8.32 |
Security Health Setting Professional Modifier None Typical Low $6.03 Median $20.42 Typical High $27.54 | Professional | None | $6.03 | $20.42 | $27.54 |
United Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $10.47 | Facility | None | $4.68 | $4.68 | $10.47 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.89 Typical High $14.79 | Professional | None | $2.34 | $3.89 | $14.79 |
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 $2.34 Median $2.34 Typical High $33.88 | Professional | 52 · Reduced service | $2.34 | $2.34 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $0.93 Typical High $13.49 | Professional | 53 · Discontinued | $0.93 | $0.93 | $13.49 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $2.69 Median $3.89 Typical High $5.75 | Professional | QW · Waived lab test | $2.69 | $3.89 | $5.75 |
Where Wisconsin sits
The same service costs 12.6 times more in Vermont than in Washington, DC. 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
$6.61
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.