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 $19.95 Median $19.95 Typical High $22.91 | Facility | None | $19.95 | $19.95 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.95 Typical High $85.11 | Professional | None | $19.05 | $19.95 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $39.81 Typical High $43.65 | Facility | None | $36.31 | $39.81 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $20.89 Typical High $32.36 | Professional | None | $19.95 | $20.89 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $54.95 Typical High $67.61 | Facility | None | $33.11 | $54.95 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $28.18 Typical High $57.54 | Professional | None | $21.88 | $28.18 | $57.54 |
DeanCare Setting Facility Modifier None Typical Low $19.95 Median $22.39 Typical High $34.67 | Facility | None | $19.95 | $22.39 | $34.67 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $22.39 Typical High $34.67 | Facility | None | $19.95 | $22.39 | $34.67 |
Medica Setting Professional Modifier None Typical Low $22.39 Median $25.12 Typical High $38.90 | Professional | None | $22.39 | $25.12 | $38.90 |
Network Health Setting Facility Modifier None Typical Low $22.91 Median $23.44 Typical High $30.20 | Facility | None | $22.91 | $23.44 | $30.20 |
Prevea360 Setting Facility Modifier None Typical Low $19.95 Median $22.39 Typical High $34.67 | Facility | None | $19.95 | $22.39 | $34.67 |
Quartz Setting Professional Modifier None Typical Low $30.20 Median $48.98 Typical High $53.70 | Professional | None | $30.20 | $48.98 | $53.70 |
Quartz Setting Facility Modifier None Typical Low $29.51 Median $67.61 Typical High $67.61 | Facility | None | $29.51 | $67.61 | $67.61 |
Quartz Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Security Health Setting Professional Modifier None Typical Low $21.38 Median $30.20 Typical High $37.15 | Professional | None | $21.38 | $30.20 | $37.15 |
United Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
United Setting Professional Modifier None Typical Low $22.39 Median $25.12 Typical High $38.90 | Professional | None | $22.39 | $25.12 | $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 $9.55 Median $10.00 Typical High $42.66 | Professional | 52 · Reduced service | $9.55 | $10.00 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.98 Typical High $16.98 | Professional | 53 · Discontinued | $3.80 | $3.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.02 Typical High $12.88 | Professional | 55 · Aftercare only | $2.82 | $3.02 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.00 Typical High $8.51 | Professional | 56 · Pre-op care only | $1.91 | $2.00 | $8.51 |
Where Wisconsin sits
The same service costs 1.9 times more in Alabama than in Rhode Island. 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· 24th of 51
$23.44
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.