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 $5.50 Median $5.75 Typical High $7.41 | Facility | None | $5.50 | $5.75 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.75 Typical High $72.44 | Professional | None | $5.62 | $5.75 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.23 Median $12.30 Typical High $13.18 | Facility | None | $10.23 | $12.30 | $13.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $9.55 Typical High $26.30 | Professional | None | $3.55 | $9.55 | $26.30 |
CareSource Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
CareSource Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $14.45 Typical High $19.50 | Facility | None | $12.59 | $14.45 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $8.71 Typical High $16.60 | Professional | None | $3.72 | $8.71 | $16.60 |
DeanCare Setting Facility Modifier None Typical Low $4.27 Median $23.44 Typical High $36.31 | Facility | None | $4.27 | $23.44 | $36.31 |
Medica Setting Facility Modifier None Typical Low $4.27 Median $12.02 Typical High $100.00 | Facility | None | $4.27 | $12.02 | $100.00 |
Medica Setting Professional Modifier None Typical Low $2.82 Median $5.75 Typical High $15.49 | Professional | None | $2.82 | $5.75 | $15.49 |
Network Health Setting Facility Modifier None Typical Low $5.75 Median $7.41 Typical High $13.49 | Facility | None | $5.75 | $7.41 | $13.49 |
Network Health Setting Professional Modifier None Typical Low $3.55 Median $4.79 Typical High $13.49 | Professional | None | $3.55 | $4.79 | $13.49 |
Prevea360 Setting Facility Modifier None Typical Low $3.80 Median $4.27 Typical High $6.03 | Facility | None | $3.80 | $4.27 | $6.03 |
Quartz Setting Professional Modifier None Typical Low $5.25 Median $10.96 Typical High $18.62 | Professional | None | $5.25 | $10.96 | $18.62 |
Quartz Setting Professional Modifier None Typical Low $3.09 Median $3.72 Typical High $12.30 | Professional | None | $3.09 | $3.72 | $12.30 |
Security Health Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $10.00 | Professional | None | $6.03 | $6.03 | $10.00 |
Security Health Setting Professional Modifier None Typical Low $6.03 Median $25.70 Typical High $33.11 | Professional | None | $6.03 | $25.70 | $33.11 |
United Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.79 Typical High $18.20 | Professional | None | $2.75 | $4.79 | $18.20 |
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 $2.82 Median $2.82 Typical High $38.02 | Professional | 52 · Reduced service | $2.82 | $2.82 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $15.14 | Professional | 53 · Discontinued | $1.12 | $1.12 | $15.14 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $3.31 Median $4.79 Typical High $6.92 | Professional | QW · Waived lab test | $3.31 | $4.79 | $6.92 |
Where Wisconsin sits
The same service costs 12.9 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
$7.24
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.