How much rates vary
Facilitymedian $46 · 10th to 90th $28 to $89Professionalmedian $31 · 10th to 90th $27 to $68
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 $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $100.00 | Professional | None | $29.51 | $29.51 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $58.88 Typical High $66.07 | Facility | None | $54.95 | $58.88 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $39.81 | Professional | None | $26.92 | $29.51 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $72.44 Typical High $89.13 | Facility | None | $44.67 | $72.44 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $36.31 Typical High $77.62 | Professional | None | $29.51 | $36.31 | $77.62 |
DeanCare Setting Facility Modifier None Typical Low $22.91 Median $29.51 Typical High $29.51 | Facility | None | $22.91 | $29.51 | $29.51 |
DeanCare Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $28.84 Typical High $29.51 | Facility | None | $22.39 | $28.84 | $29.51 |
Medica Setting Professional Modifier None Typical Low $25.70 Median $31.62 Typical High $44.67 | Professional | None | $25.70 | $31.62 | $44.67 |
Network Health Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $48.98 | Facility | None | $17.78 | $17.78 | $48.98 |
Prevea360 Setting Facility Modifier None Typical Low $22.91 Median $29.51 Typical High $29.51 | Facility | None | $22.91 | $29.51 | $29.51 |
Prevea360 Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Quartz Setting Professional Modifier None Typical Low $29.51 Median $46.77 Typical High $77.62 | Professional | None | $29.51 | $46.77 | $77.62 |
Quartz Setting Facility Modifier None Typical Low $38.90 Median $89.13 Typical High $89.13 | Facility | None | $38.90 | $89.13 | $89.13 |
Quartz Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Security Health Setting Professional Modifier None Typical Low $27.54 Median $39.81 Typical High $48.98 | Professional | None | $27.54 | $39.81 | $48.98 |
United Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
United Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $45.71 | Professional | None | $26.30 | $30.90 | $45.71 |
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 $14.79 Median $14.79 Typical High $57.54 | Professional | 52 · Reduced service | $14.79 | $14.79 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $22.91 | Professional | 53 · Discontinued | $5.89 | $5.89 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $16.98 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $11.48 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $11.48 |
Where Wisconsin sits
Rates are fairly even across states for this service. 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· 11th of 51
$31.62
AL $38.90RI $26.30
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.