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 $5.62 Median $5.62 Typical High $7.24 | Facility | None | $5.62 | $5.62 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $5.62 Typical High $53.70 | Professional | None | $5.01 | $5.62 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.23 Median $12.30 Typical High $12.88 | Facility | None | $10.23 | $12.30 | $12.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $7.94 Typical High $31.62 | Professional | None | $2.14 | $7.94 | $31.62 |
CareSource Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
CareSource Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
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 $2.75 Median $8.71 Typical High $14.79 | Professional | None | $2.75 | $8.71 | $14.79 |
DeanCare Setting Facility Modifier None Typical Low $3.80 Median $21.38 Typical High $33.11 | Facility | None | $3.80 | $21.38 | $33.11 |
Medica Setting Facility Modifier None Typical Low $3.80 Median $4.68 Typical High $100.00 | Facility | None | $3.80 | $4.68 | $100.00 |
Medica Setting Professional Modifier None Typical Low $2.75 Median $4.68 Typical High $14.13 | Professional | None | $2.75 | $4.68 | $14.13 |
Network Health Setting Facility Modifier None Typical Low $5.62 Median $6.61 Typical High $12.30 | Facility | None | $5.62 | $6.61 | $12.30 |
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 $4.17 Typical High $6.03 | Facility | None | $3.80 | $4.17 | $6.03 |
Quartz Setting Professional Modifier None Typical Low $5.25 Median $10.96 Typical High $18.20 | Professional | None | $5.25 | $10.96 | $18.20 |
Quartz Setting Professional Modifier None Typical Low $2.29 Median $2.75 Typical High $12.30 | Professional | None | $2.29 | $2.75 | $12.30 |
Security Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $12.88 | Professional | None | $10.00 | $10.00 | $12.88 |
Security Health Setting Professional Modifier None Typical Low $12.88 Median $20.42 Typical High $33.11 | Professional | None | $12.88 | $20.42 | $33.11 |
United Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.80 Typical High $16.60 | Professional | None | $2.34 | $3.80 | $16.60 |
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 $2.82 Median $2.82 Typical High $26.92 | Professional | 52 · Reduced service | $2.82 | $2.82 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $10.72 | Professional | 53 · Discontinued | $1.12 | $1.12 | $10.72 |
Where Wisconsin sits
The same service costs 3.5 times more in Kansas than in Maryland. 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
$6.92
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.