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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $524.81 | Professional | None | $229.09 | $229.09 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $275.42 | Professional | None | $208.93 | $229.09 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $457.09 Typical High $776.25 | Facility | None | $338.84 | $457.09 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $251.19 | Professional | None | $213.80 | $239.88 | $251.19 |
DeanCare Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $251.19 | Facility | None | $208.93 | $251.19 | $251.19 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $416.87 | Facility | None | $208.93 | $251.19 | $416.87 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $354.81 | Professional | None | $208.93 | $251.19 | $354.81 |
Network Health Setting Facility Modifier None Typical Low $218.78 Median $239.88 Typical High $239.88 | Facility | None | $218.78 | $239.88 | $239.88 |
Prevea360 Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $251.19 | Facility | None | $208.93 | $251.19 | $251.19 |
Quartz Setting Facility Modifier None Typical Low $338.84 Median $776.25 Typical High $776.25 | Facility | None | $338.84 | $776.25 | $776.25 |
Quartz Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Security Health Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $144.54 | Professional | None | $100.00 | $117.49 | $144.54 |
United Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $389.05 | Professional | None | $223.87 | $269.15 | $389.05 |
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 $114.82 Median $114.82 Typical High $263.03 | Professional | 52 · Reduced service | $114.82 | $114.82 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $104.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $79.43 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $52.48 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $52.48 |
Where Wisconsin sits
The same service costs 2.0 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· 30th of 51
$240
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.