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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $109.65 | Professional | None | $67.61 | $67.61 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $67.61 Typical High $74.13 | Professional | None | $39.81 | $67.61 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $158.49 Typical High $223.87 | Facility | None | $97.72 | $158.49 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $67.61 Typical High $79.43 | Professional | None | $33.88 | $67.61 | $79.43 |
DeanCare Setting Facility Modifier None Typical Low $19.50 Median $37.15 Typical High $79.43 | Facility | None | $19.50 | $37.15 | $79.43 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $37.15 Typical High $79.43 | Facility | None | $19.50 | $37.15 | $79.43 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $114.82 | Professional | None | $66.07 | $79.43 | $114.82 |
Network Health Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Prevea360 Setting Facility Modifier None Typical Low $19.50 Median $37.15 Typical High $79.43 | Facility | None | $19.50 | $37.15 | $79.43 |
Quartz Setting Professional Modifier None Typical Low $20.42 Median $41.69 Typical High $57.54 | Professional | None | $20.42 | $41.69 | $57.54 |
Quartz Setting Facility Modifier None Typical Low $97.72 Median $223.87 Typical High $223.87 | Facility | None | $97.72 | $223.87 | $223.87 |
Quartz Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Security Health Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $50.12 | Professional | None | $33.88 | $40.74 | $50.12 |
United Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $114.82 | Professional | None | $66.07 | $79.43 | $114.82 |
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 $33.88 Median $33.88 Typical High $54.95 | Professional | 52 · Reduced service | $33.88 | $33.88 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $21.88 | Professional | 53 · Discontinued | $13.49 | $13.49 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $16.22 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $10.96 |
Where Wisconsin sits
The same service costs 6.5 times more in Arizona than in Hawaii. 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· 41st of 51
$67.61
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.