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 $26.30 Median $26.30 Typical High $33.88 | Facility | None | $26.30 | $26.30 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $389.05 | Professional | None | $25.70 | $26.30 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $56.23 Typical High $60.26 | Facility | None | $46.77 | $56.23 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $36.31 Typical High $158.49 | Professional | None | $10.72 | $36.31 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
CareSource Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $63.10 Typical High $83.18 | Facility | None | $53.70 | $63.10 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $37.15 Typical High $67.61 | Professional | None | $14.45 | $37.15 | $67.61 |
DeanCare Setting Facility Modifier None Typical Low $19.50 Median $107.15 Typical High $169.82 | Facility | None | $19.50 | $107.15 | $169.82 |
Medica Setting Facility Modifier None Typical Low $17.78 Median $26.30 Typical High $109.65 | Facility | None | $17.78 | $26.30 | $109.65 |
Medica Setting Professional Modifier None Typical Low $12.88 Median $21.88 Typical High $70.79 | Professional | None | $12.88 | $21.88 | $70.79 |
Network Health Setting Facility Modifier None Typical Low $26.30 Median $33.88 Typical High $61.66 | Facility | None | $26.30 | $33.88 | $61.66 |
Network Health Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $61.66 | Professional | None | $16.22 | $22.39 | $61.66 |
Prevea360 Setting Facility Modifier None Typical Low $17.38 Median $19.50 Typical High $27.54 | Facility | None | $17.38 | $19.50 | $27.54 |
Quartz Setting Professional Modifier None Typical Low $23.99 Median $51.29 Typical High $91.20 | Professional | None | $23.99 | $51.29 | $91.20 |
Quartz Setting Professional Modifier None Typical Low $10.47 Median $14.45 Typical High $56.23 | Professional | None | $10.47 | $14.45 | $56.23 |
Security Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $46.77 | Professional | None | $34.67 | $34.67 | $46.77 |
Security Health Setting Professional Modifier None Typical Low $34.67 Median $79.43 Typical High $151.36 | Professional | None | $34.67 | $79.43 | $151.36 |
United Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
United Setting Professional Modifier None Typical Low $10.96 Median $18.20 Typical High $83.18 | Professional | None | $10.96 | $18.20 | $83.18 |
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 $13.18 Median $13.18 Typical High $190.55 | Professional | 52 · Reduced service | $13.18 | $13.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $77.62 | Professional | 53 · Discontinued | $5.25 | $5.25 | $77.62 |
Where Wisconsin sits
The same service costs 4.8 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· 8th of 51
$33.88
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.