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 $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $102.33 | Professional | None | $32.36 | $32.36 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $57.54 | Professional | None | $31.62 | $34.67 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $69.18 Typical High $104.71 | Facility | None | $45.71 | $69.18 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $50.12 | Professional | None | $34.67 | $40.74 | $50.12 |
DeanCare Setting Facility Modifier None Typical Low $23.99 Median $34.67 Typical High $45.71 | Facility | None | $23.99 | $34.67 | $45.71 |
Medica Setting Facility Modifier None Typical Low $23.99 Median $34.67 Typical High $158.49 | Facility | None | $23.99 | $34.67 | $158.49 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $35.48 Typical High $51.29 | Professional | None | $30.20 | $35.48 | $51.29 |
Network Health Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Prevea360 Setting Facility Modifier None Typical Low $23.99 Median $34.67 Typical High $45.71 | Facility | None | $23.99 | $34.67 | $45.71 |
Quartz Setting Professional Modifier None Typical Low $29.51 Median $53.70 Typical High $67.61 | Professional | None | $29.51 | $53.70 | $67.61 |
Quartz Setting Facility Modifier None Typical Low $45.71 Median $104.71 Typical High $104.71 | Facility | None | $45.71 | $104.71 | $104.71 |
Quartz Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $70.79 | Professional | None | $34.67 | $34.67 | $70.79 |
Security Health Setting Professional Modifier None Typical Low $32.36 Median $38.90 Typical High $47.86 | Professional | None | $32.36 | $38.90 | $47.86 |
United Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $53.70 | Professional | None | $30.90 | $37.15 | $53.70 |
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 $16.22 Median $16.22 Typical High $51.29 | Professional | 52 · Reduced service | $16.22 | $16.22 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $20.42 | Professional | 53 · Discontinued | $6.46 | $6.46 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $15.49 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $10.23 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $10.23 |
Where Wisconsin sits
The same service costs 5.4 times more in Arizona 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· 8th of 51
$36.31
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.