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 $6.61 Median $6.61 Typical High $9.33 | Facility | None | $6.61 | $6.61 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $6.61 Typical High $151.36 | Professional | None | $6.46 | $6.61 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.75 Median $14.45 Typical High $15.14 | Facility | None | $11.75 | $14.45 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $9.12 Typical High $39.81 | Professional | None | $2.69 | $9.12 | $39.81 |
CareSource Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $15.85 Typical High $20.89 | Facility | None | $13.49 | $15.85 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $9.33 Typical High $17.38 | Professional | None | $3.63 | $9.33 | $17.38 |
DeanCare Setting Facility Modifier None Typical Low $4.90 Median $27.54 Typical High $42.66 | Facility | None | $4.90 | $27.54 | $42.66 |
Medica Setting Facility Modifier None Typical Low $4.37 Median $5.62 Typical High $100.00 | Facility | None | $4.37 | $5.62 | $100.00 |
Medica Setting Professional Modifier None Typical Low $3.31 Median $5.50 Typical High $18.20 | Professional | None | $3.31 | $5.50 | $18.20 |
Network Health Setting Facility Modifier None Typical Low $6.61 Median $8.51 Typical High $15.85 | Facility | None | $6.61 | $8.51 | $15.85 |
Network Health Setting Professional Modifier None Typical Low $4.17 Median $5.62 Typical High $15.49 | Professional | None | $4.17 | $5.62 | $15.49 |
Prevea360 Setting Facility Modifier None Typical Low $4.37 Median $5.01 Typical High $7.08 | Facility | None | $4.37 | $5.01 | $7.08 |
Quartz Setting Professional Modifier None Typical Low $5.89 Median $12.59 Typical High $22.91 | Professional | None | $5.89 | $12.59 | $22.91 |
Quartz Setting Professional Modifier None Typical Low $2.63 Median $3.63 Typical High $14.45 | Professional | None | $2.63 | $3.63 | $14.45 |
Security Health Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $64.57 | Professional | None | $11.75 | $11.75 | $64.57 |
Security Health Setting Professional Modifier None Typical Low $21.88 Median $38.90 Typical High $64.57 | Professional | None | $21.88 | $38.90 | $64.57 |
United Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $12.02 | Facility | None | $6.61 | $6.61 | $12.02 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.68 Typical High $20.89 | Professional | None | $2.75 | $4.68 | $20.89 |
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 $3.31 Median $3.31 Typical High $75.86 | Professional | 52 · Reduced service | $3.31 | $3.31 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.32 Typical High $30.20 | Professional | 53 · Discontinued | $1.32 | $1.32 | $30.20 |
Where Wisconsin sits
The same service costs 12.3 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· 6th of 51
$8.32
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.