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 $4.37 Median $4.37 Typical High $5.62 | Facility | None | $4.37 | $4.37 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $57.54 | Professional | None | $4.37 | $4.37 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.94 Median $9.55 Typical High $10.00 | Facility | None | $7.94 | $9.55 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $7.41 Typical High $26.92 | Professional | None | $2.69 | $7.41 | $26.92 |
CareSource Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
CareSource Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
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 $2.45 Median $6.17 Typical High $11.48 | Professional | None | $2.45 | $6.17 | $11.48 |
DeanCare Setting Facility Modifier None Typical Low $3.24 Median $18.20 Typical High $28.18 | Facility | None | $3.24 | $18.20 | $28.18 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $7.41 Typical High $70.79 | Facility | None | $3.24 | $7.41 | $70.79 |
Medica Setting Professional Modifier None Typical Low $2.19 Median $3.63 Typical High $12.02 | Professional | None | $2.19 | $3.63 | $12.02 |
Network Health Setting Facility Modifier None Typical Low $4.37 Median $5.62 Typical High $10.47 | Facility | None | $4.37 | $5.62 | $10.47 |
Network Health Setting Professional Modifier None Typical Low $2.75 Median $3.72 Typical High $10.47 | Professional | None | $2.75 | $3.72 | $10.47 |
Prevea360 Setting Facility Modifier None Typical Low $2.95 Median $3.31 Typical High $4.68 | Facility | None | $2.95 | $3.31 | $4.68 |
Quartz Setting Professional Modifier None Typical Low $4.07 Median $8.71 Typical High $15.49 | Professional | None | $4.07 | $8.71 | $15.49 |
Quartz Setting Professional Modifier None Typical Low $1.70 Median $2.45 Typical High $9.55 | Professional | None | $1.70 | $2.45 | $9.55 |
Security Health Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.76 | Professional | None | $6.03 | $6.03 | $7.76 |
Security Health Setting Professional Modifier None Typical Low $6.03 Median $19.95 Typical High $25.70 | Professional | None | $6.03 | $19.95 | $25.70 |
United Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $10.47 | Facility | None | $4.37 | $4.37 | $10.47 |
United Setting Professional Modifier None Typical Low $1.82 Median $3.09 Typical High $14.13 | Professional | None | $1.82 | $3.09 | $14.13 |
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 $2.19 Median $2.19 Typical High $39.81 | Professional | 52 · Reduced service | $2.19 | $2.19 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.87 Typical High $15.85 | Professional | 53 · Discontinued | $0.87 | $0.87 | $15.85 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $2.51 Median $3.63 Typical High $5.37 | Professional | QW · Waived lab test | $2.51 | $3.63 | $5.37 |
Where Wisconsin sits
The same service costs 10.2 times more in Vermont 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
$5.75
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.