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 $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $645.65 | Professional | None | $257.04 | $338.84 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $407.38 | Professional | None | $302.00 | $338.84 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $1,122.02 | Facility | None | $489.78 | $691.83 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $371.54 | Professional | None | $323.59 | $363.08 | $371.54 |
DeanCare Setting Facility Modifier None Typical Low $338.84 Median $398.11 Typical High $398.11 | Facility | None | $338.84 | $398.11 | $398.11 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $501.19 Typical High $660.69 | Facility | None | $316.23 | $501.19 | $660.69 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $524.81 | Professional | None | $309.03 | $371.54 | $524.81 |
Network Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Prevea360 Setting Facility Modifier None Typical Low $338.84 Median $398.11 Typical High $398.11 | Facility | None | $338.84 | $398.11 | $398.11 |
Quartz Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $1,122.02 | Facility | None | $489.78 | $1,122.02 | $1,122.02 |
Quartz Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Security Health Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $275.42 | Professional | None | $186.21 | $223.87 | $275.42 |
United Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $562.34 | Professional | None | $331.13 | $398.11 | $562.34 |
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 $112.20 Median $165.96 Typical High $288.40 | Professional | 52 · Reduced service | $112.20 | $165.96 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $67.61 Typical High $117.49 | Professional | 53 · Discontinued | $44.67 | $67.61 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $50.12 Typical High $87.10 | Professional | 55 · Aftercare only | $33.11 | $50.12 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $33.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $22.39 | $33.88 | $58.88 |
Where Wisconsin sits
The same service costs 3.0 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· 29th of 51
$355
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.