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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $363.08 | Professional | None | $120.23 | $120.23 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $128.82 | Professional | None | $70.79 | $117.49 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $257.04 Typical High $416.87 | Facility | None | $181.97 | $257.04 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $109.65 Typical High $138.04 | Professional | None | $61.66 | $109.65 | $138.04 |
DeanCare Setting Facility Modifier None Typical Low $36.31 Median $69.18 Typical High $141.25 | Facility | None | $36.31 | $69.18 | $141.25 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $69.18 Typical High $128.82 | Facility | None | $36.31 | $69.18 | $128.82 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $204.17 | Professional | None | $117.49 | $141.25 | $204.17 |
Network Health Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Prevea360 Setting Facility Modifier None Typical Low $36.31 Median $69.18 Typical High $141.25 | Facility | None | $36.31 | $69.18 | $141.25 |
Quartz Setting Professional Modifier None Typical Low $45.71 Median $83.18 Typical High $102.33 | Professional | None | $45.71 | $83.18 | $102.33 |
Quartz Setting Facility Modifier None Typical Low $181.97 Median $416.87 Typical High $416.87 | Facility | None | $181.97 | $416.87 | $416.87 |
Quartz Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Security Health Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $70.79 | Professional | None | $50.12 | $57.54 | $70.79 |
United Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $204.17 | Professional | None | $117.49 | $141.25 | $204.17 |
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 $60.26 Median $60.26 Typical High $181.97 | Professional | 52 · Reduced service | $60.26 | $60.26 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $72.44 | Professional | 53 · Discontinued | $23.99 | $23.99 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $53.70 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $36.31 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $36.31 |
Where Wisconsin sits
The same service costs 5.1 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· 32nd of 51
$120
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.