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 $2.82 Median $2.82 Typical High $3.63 | Facility | None | $2.82 | $2.82 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $2.82 Typical High $33.88 | Professional | None | $2.75 | $2.82 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $6.17 Typical High $6.46 | Facility | None | $5.13 | $6.17 | $6.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.78 Median $4.79 Typical High $13.18 | Professional | None | $1.78 | $4.79 | $13.18 |
CareSource Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
CareSource Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $6.31 Typical High $8.32 | Facility | None | $5.37 | $6.31 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $3.72 Typical High $8.13 | Professional | None | $1.74 | $3.72 | $8.13 |
DeanCare Setting Facility Modifier None Typical Low $2.09 Median $11.75 Typical High $18.20 | Facility | None | $2.09 | $11.75 | $18.20 |
Medica Setting Facility Modifier None Typical Low $2.09 Median $14.79 Typical High $58.88 | Facility | None | $2.09 | $14.79 | $58.88 |
Medica Setting Professional Modifier None Typical Low $1.41 Median $2.82 Typical High $7.76 | Professional | None | $1.41 | $2.82 | $7.76 |
Network Health Setting Facility Modifier None Typical Low $2.82 Median $3.63 Typical High $6.76 | Facility | None | $2.82 | $3.63 | $6.76 |
Network Health Setting Professional Modifier None Typical Low $1.78 Median $2.40 Typical High $6.76 | Professional | None | $1.78 | $2.40 | $6.76 |
Prevea360 Setting Facility Modifier None Typical Low $1.91 Median $2.14 Typical High $3.02 | Facility | None | $1.91 | $2.14 | $3.02 |
Quartz Setting Professional Modifier None Typical Low $2.88 Median $5.89 Typical High $14.13 | Professional | None | $2.88 | $5.89 | $14.13 |
Quartz Setting Professional Modifier None Typical Low $1.62 Median $1.74 Typical High $6.17 | Professional | None | $1.62 | $1.74 | $6.17 |
Security Health Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $7.24 | Professional | None | $5.01 | $5.01 | $7.24 |
Security Health Setting Professional Modifier None Typical Low $7.24 Median $9.33 Typical High $16.60 | Professional | None | $7.24 | $9.33 | $16.60 |
United Setting Facility Modifier None Typical Low $2.82 Median $2.82 Typical High $7.59 | Facility | None | $2.82 | $2.82 | $7.59 |
United Setting Professional Modifier None Typical Low $1.41 Median $2.34 Typical High $9.12 | Professional | None | $1.41 | $2.34 | $9.12 |
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 $1.41 Median $1.41 Typical High $30.90 | Professional | 52 · Reduced service | $1.41 | $1.41 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $12.30 | Professional | 53 · Discontinued | $0.56 | $0.56 | $12.30 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $1.62 Median $2.34 Typical High $3.47 | Professional | QW · Waived lab test | $1.62 | $2.34 | $3.47 |
Where Wisconsin sits
The same service costs 17.0 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· 10th of 51
$3.98
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.