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 $5.25 Median $5.37 Typical High $6.92 | Facility | None | $5.25 | $5.37 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $67.61 | Professional | None | $5.37 | $5.37 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.77 Median $11.75 Typical High $12.30 | Facility | None | $9.77 | $11.75 | $12.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $9.12 Typical High $33.11 | Professional | None | $3.39 | $9.12 | $33.11 |
CareSource Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
CareSource Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $13.49 Typical High $18.20 | Facility | None | $11.75 | $13.49 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $7.94 Typical High $14.13 | Professional | None | $2.95 | $7.94 | $14.13 |
DeanCare Setting Facility Modifier None Typical Low $3.98 Median $22.39 Typical High $34.67 | Facility | None | $3.98 | $22.39 | $34.67 |
Medica Setting Facility Modifier None Typical Low $3.98 Median $37.15 Typical High $100.00 | Facility | None | $3.98 | $37.15 | $100.00 |
Medica Setting Professional Modifier None Typical Low $2.69 Median $4.47 Typical High $16.22 | Professional | None | $2.69 | $4.47 | $16.22 |
Network Health Setting Facility Modifier None Typical Low $5.37 Median $6.92 Typical High $12.88 | Facility | None | $5.37 | $6.92 | $12.88 |
Network Health Setting Professional Modifier None Typical Low $3.39 Median $4.57 Typical High $12.88 | Professional | None | $3.39 | $4.57 | $12.88 |
Prevea360 Setting Facility Modifier None Typical Low $3.63 Median $4.07 Typical High $5.75 | Facility | None | $3.63 | $4.07 | $5.75 |
Quartz Setting Professional Modifier None Typical Low $5.25 Median $10.96 Typical High $19.05 | Professional | None | $5.25 | $10.96 | $19.05 |
Quartz Setting Professional Modifier None Typical Low $2.19 Median $2.95 Typical High $11.75 | Professional | None | $2.19 | $2.95 | $11.75 |
Security Health Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $9.55 | Professional | None | $6.03 | $6.03 | $9.55 |
Security Health Setting Professional Modifier None Typical Low $6.03 Median $22.39 Typical High $31.62 | Professional | None | $6.03 | $22.39 | $31.62 |
United Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $10.47 | Facility | None | $5.37 | $5.37 | $10.47 |
United Setting Professional Modifier None Typical Low $2.24 Median $3.80 Typical High $17.38 | Professional | None | $2.24 | $3.80 | $17.38 |
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 $2.69 Median $2.69 Typical High $39.81 | Professional | 52 · Reduced service | $2.69 | $2.69 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $15.85 | Professional | 53 · Discontinued | $1.07 | $1.07 | $15.85 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $3.09 Median $4.47 Typical High $6.61 | Professional | QW · Waived lab test | $3.09 | $4.47 | $6.61 |
Where Wisconsin sits
The same service costs 15.8 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· 12th 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.