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 $4.27 Median $4.27 Typical High $5.50 | Facility | None | $4.27 | $4.27 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.27 Typical High $43.65 | Professional | None | $4.17 | $4.27 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.76 Median $9.33 Typical High $9.77 | Facility | None | $7.76 | $9.33 | $9.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.78 Median $7.24 Typical High $19.95 | Professional | None | $1.78 | $7.24 | $19.95 |
CareSource Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Facility | None | $1.95 | $1.95 | $1.95 |
CareSource Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
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 $2.29 Median $6.17 Typical High $12.30 | Professional | None | $2.29 | $6.17 | $12.30 |
DeanCare Setting Facility Modifier None Typical Low $3.16 Median $17.78 Typical High $27.54 | Facility | None | $3.16 | $17.78 | $27.54 |
Medica Setting Facility Modifier None Typical Low $2.95 Median $4.27 Typical High $100.00 | Facility | None | $2.95 | $4.27 | $100.00 |
Medica Setting Professional Modifier None Typical Low $2.14 Median $4.27 Typical High $11.75 | Professional | None | $2.14 | $4.27 | $11.75 |
Network Health Setting Facility Modifier None Typical Low $4.27 Median $5.50 Typical High $10.23 | Facility | None | $4.27 | $5.50 | $10.23 |
Network Health Setting Professional Modifier None Typical Low $2.69 Median $3.63 Typical High $10.23 | Professional | None | $2.69 | $3.63 | $10.23 |
Prevea360 Setting Facility Modifier None Typical Low $2.88 Median $3.24 Typical High $4.57 | Facility | None | $2.88 | $3.24 | $4.57 |
Quartz Setting Professional Modifier None Typical Low $4.07 Median $8.71 Typical High $14.13 | Professional | None | $4.07 | $8.71 | $14.13 |
Quartz Setting Professional Modifier None Typical Low $1.70 Median $2.29 Typical High $9.33 | Professional | None | $1.70 | $2.29 | $9.33 |
Security Health Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $7.59 | Professional | None | $6.76 | $6.76 | $7.59 |
Security Health Setting Professional Modifier None Typical Low $6.76 Median $16.60 Typical High $25.12 | Professional | None | $6.76 | $16.60 | $25.12 |
United Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
United Setting Professional Modifier None Typical Low $2.14 Median $3.55 Typical High $13.49 | Professional | None | $2.14 | $3.55 | $13.49 |
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 $2.14 Median $2.14 Typical High $21.88 | Professional | 52 · Reduced service | $2.14 | $2.14 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $8.71 | Professional | 53 · Discontinued | $0.85 | $0.85 | $8.71 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $2.45 Median $3.55 Typical High $5.25 | Professional | QW · Waived lab test | $2.45 | $3.55 | $5.25 |
Where Wisconsin sits
The same service costs 3.5 times more in Kansas than in Tennessee. 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· 8th of 51
$5.62
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.