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 $3.02 Typical High $56.23 | Professional | None | $3.02 | $3.02 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.22 Median $23.44 Typical High $41.69 | Professional | None | $11.22 | $23.44 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $37.15 Typical High $54.95 | Facility | None | $32.36 | $37.15 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $25.70 Typical High $33.11 | Professional | None | $11.22 | $25.70 | $33.11 |
DeanCare Setting Facility Modifier None Typical Low $4.37 Median $13.49 Typical High $25.12 | Facility | None | $4.37 | $13.49 | $25.12 |
DeanCare Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Medica Setting Facility Modifier None Typical Low $4.37 Median $14.13 Typical High $47.86 | Facility | None | $4.37 | $14.13 | $47.86 |
Medica Setting Professional Modifier None Typical Low $12.02 Median $22.39 Typical High $40.74 | Professional | None | $12.02 | $22.39 | $40.74 |
Network Health Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $25.12 | Facility | None | $19.05 | $19.05 | $25.12 |
Prevea360 Setting Facility Modifier None Typical Low $4.37 Median $13.49 Typical High $25.12 | Facility | None | $4.37 | $13.49 | $25.12 |
Prevea360 Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Quartz Setting Professional Modifier None Typical Low $13.80 Median $25.70 Typical High $37.15 | Professional | None | $13.80 | $25.70 | $37.15 |
Quartz Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $22.91 | Professional | None | $11.22 | $11.22 | $22.91 |
Security Health Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Security Health Setting Facility Modifier None Typical Low $13.80 Median $16.60 Typical High $18.62 | Facility | None | $13.80 | $16.60 | $18.62 |
Security Health Setting Professional Modifier None Typical Low $15.14 Median $19.05 Typical High $41.69 | Professional | None | $15.14 | $19.05 | $41.69 |
United Setting Professional Modifier None Typical Low $11.75 Median $18.62 Typical High $41.69 | Professional | None | $11.75 | $18.62 | $41.69 |
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 $28.84 | Professional | 52 · Reduced service | $1.51 | $1.51 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $11.48 | Professional | 53 · Discontinued | $0.60 | $0.60 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $8.71 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $5.75 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $5.75 |
Where Wisconsin sits
The same service costs 6.6 times more in Alabama 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· 5th of 51
$22.39
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.