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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $239.88 | Professional | None | $194.98 | $194.98 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $323.59 | Professional | None | $186.21 | $199.53 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $380.19 Typical High $645.65 | Facility | None | $281.84 | $380.19 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $371.54 | Professional | None | $186.21 | $213.80 | $371.54 |
DeanCare Setting Facility Modifier None Typical Low $114.82 Median $141.25 Typical High $251.19 | Facility | None | $114.82 | $141.25 | $251.19 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $141.25 Typical High $251.19 | Facility | None | $114.82 | $141.25 | $251.19 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $302.00 | Professional | None | $177.83 | $213.80 | $302.00 |
Network Health Setting Facility Modifier None Typical Low $177.83 Median $199.53 Typical High $199.53 | Facility | None | $177.83 | $199.53 | $199.53 |
Prevea360 Setting Facility Modifier None Typical Low $114.82 Median $141.25 Typical High $251.19 | Facility | None | $114.82 | $141.25 | $251.19 |
Quartz Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $346.74 | Professional | None | $147.91 | $269.15 | $346.74 |
Quartz Setting Facility Modifier None Typical Low $281.84 Median $645.65 Typical High $645.65 | Facility | None | $281.84 | $645.65 | $645.65 |
Quartz Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Security Health Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $234.42 | Professional | None | $158.49 | $190.55 | $234.42 |
United Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $323.59 | Professional | None | $190.55 | $229.09 | $323.59 |
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 $95.50 Median $95.50 Typical High $120.23 | Professional | 52 · Reduced service | $95.50 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $47.86 | Professional | 53 · Discontinued | $38.90 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $35.48 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $23.99 |
Where Wisconsin sits
The same service costs 8.3 times more in Arizona than in Alabama. 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· 17th of 51
$214
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.