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 Professional Modifier None Typical Low $23.44 Median $97.72 Typical High $102.33 | Professional | None | $23.44 | $97.72 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $31.62 | Professional | None | $19.50 | $19.50 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $52.48 Typical High $64.57 | Facility | None | $32.36 | $52.48 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $27.54 Typical High $53.70 | Professional | None | $21.38 | $27.54 | $53.70 |
DeanCare Setting Facility Modifier None Typical Low $19.50 Median $21.88 Typical High $39.81 | Facility | None | $19.50 | $21.88 | $39.81 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $21.88 Typical High $39.81 | Facility | None | $14.79 | $21.88 | $39.81 |
Medica Setting Professional Modifier None Typical Low $22.91 Median $25.70 Typical High $38.90 | Professional | None | $22.91 | $25.70 | $38.90 |
Network Health Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Prevea360 Setting Facility Modifier None Typical Low $19.50 Median $21.88 Typical High $39.81 | Facility | None | $19.50 | $21.88 | $39.81 |
Quartz Setting Professional Modifier None Typical Low $30.20 Median $54.95 Typical High $57.54 | Professional | None | $30.20 | $54.95 | $57.54 |
Quartz Setting Facility Modifier None Typical Low $28.18 Median $64.57 Typical High $64.57 | Facility | None | $28.18 | $64.57 | $64.57 |
Quartz Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Security Health Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $36.31 | Professional | None | $29.51 | $29.51 | $36.31 |
United Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
United Setting Professional Modifier None Typical Low $22.91 Median $25.70 Typical High $38.90 | Professional | None | $22.91 | $25.70 | $38.90 |
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 $41.69 Median $48.98 Typical High $51.29 | Professional | 52 · Reduced service | $41.69 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.50 Typical High $20.42 | Professional | 53 · Discontinued | $16.60 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.45 Typical High $15.49 | Professional | 55 · Aftercare only | $12.59 | $14.45 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.77 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.32 | $9.77 | $10.23 |
Where Wisconsin sits
The same service costs 2.0 times more in Alabama than in Connecticut. 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· 5th of 51
$25.70
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.