How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.16 Typical High $72.44 | Professional | None | $3.02 | $3.16 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $35.48 Typical High $69.18 | Professional | None | $15.85 | $35.48 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $51.29 Typical High $75.86 | Facility | None | $44.67 | $51.29 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $35.48 Typical High $46.77 | Professional | None | $15.49 | $35.48 | $46.77 |
DeanCare Setting Facility Modifier None Typical Low $4.37 Median $18.62 Typical High $34.67 | Facility | None | $4.37 | $18.62 | $34.67 |
DeanCare Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medica Setting Facility Modifier None Typical Low $15.49 Median $31.62 Typical High $181.97 | Facility | None | $15.49 | $31.62 | $181.97 |
Medica Setting Professional Modifier None Typical Low $13.80 Median $30.90 Typical High $61.66 | Professional | None | $13.80 | $30.90 | $61.66 |
Network Health Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $51.29 | Facility | None | $25.12 | $25.12 | $51.29 |
Prevea360 Setting Facility Modifier None Typical Low $4.37 Median $18.62 Typical High $34.67 | Facility | None | $4.37 | $18.62 | $34.67 |
Prevea360 Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Quartz Setting Professional Modifier None Typical Low $19.05 Median $36.31 Typical High $52.48 | Professional | None | $19.05 | $36.31 | $52.48 |
Quartz Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $46.77 | Professional | None | $15.49 | $15.49 | $46.77 |
Security Health Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Security Health Setting Facility Modifier None Typical Low $18.20 Median $21.88 Typical High $25.12 | Facility | None | $18.20 | $21.88 | $25.12 |
Security Health Setting Professional Modifier None Typical Low $21.88 Median $27.54 Typical High $57.54 | Professional | None | $21.88 | $27.54 | $57.54 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $13.49 Median $24.55 Typical High $67.61 | Professional | None | $13.49 | $24.55 | $67.61 |
4 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 $1.51 Median $1.51 Typical High $36.31 | Professional | 52 · Reduced service | $1.51 | $1.51 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $14.45 | Professional | 53 · Discontinued | $0.60 | $0.60 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $10.96 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $7.24 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $7.24 |
Where Wisconsin sits
The same service costs 5.2 times more in Texas than in Kentucky. 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
$30.90
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.