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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $114.82 | Professional | None | $25.12 | $25.12 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $45.71 Median $48.98 Typical High $54.95 | Facility | None | $45.71 | $48.98 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $25.12 Typical High $40.74 | Professional | None | $24.55 | $25.12 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $67.61 Typical High $83.18 | Facility | None | $41.69 | $67.61 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $70.79 | Professional | None | $27.54 | $35.48 | $70.79 |
DeanCare Setting Facility Modifier None Typical Low $25.12 Median $27.54 Typical High $48.98 | Facility | None | $25.12 | $27.54 | $48.98 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $27.54 Typical High $48.98 | Facility | None | $25.12 | $27.54 | $48.98 |
Medica Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $47.86 | Professional | None | $27.54 | $31.62 | $47.86 |
Network Health Setting Facility Modifier None Typical Low $28.18 Median $29.51 Typical High $41.69 | Facility | None | $28.18 | $29.51 | $41.69 |
Prevea360 Setting Facility Modifier None Typical Low $25.12 Median $27.54 Typical High $48.98 | Facility | None | $25.12 | $27.54 | $48.98 |
Quartz Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $70.79 | Professional | None | $30.20 | $30.20 | $70.79 |
Quartz Setting Facility Modifier None Typical Low $36.31 Median $83.18 Typical High $83.18 | Facility | None | $36.31 | $83.18 | $83.18 |
Quartz Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Security Health Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $45.71 | Professional | None | $30.20 | $37.15 | $45.71 |
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 $27.54 Median $31.62 Typical High $47.86 | Professional | None | $27.54 | $31.62 | $47.86 |
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 $12.30 Median $12.30 Typical High $57.54 | Professional | 52 · Reduced service | $12.30 | $12.30 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $23.44 | Professional | 53 · Discontinued | $5.01 | $5.01 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $17.38 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $11.48 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $11.48 |
Where Wisconsin sits
The same service costs 1.5 times more in Arizona than in Georgia. 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· 12th of 51
$29.51
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.