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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $245.47 | Professional | None | $102.33 | $102.33 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $131.83 | Professional | None | $91.20 | $100.00 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $331.13 | Facility | None | $144.54 | $223.87 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $120.23 | Professional | None | $81.28 | $95.50 | $120.23 |
DeanCare Setting Facility Modifier None Typical Low $47.86 Median $91.20 Typical High $114.82 | Facility | None | $47.86 | $91.20 | $114.82 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $100.00 Typical High $144.54 | Facility | None | $47.86 | $100.00 | $144.54 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $165.96 | Professional | None | $95.50 | $114.82 | $165.96 |
Network Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Prevea360 Setting Facility Modifier None Typical Low $47.86 Median $91.20 Typical High $114.82 | Facility | None | $47.86 | $91.20 | $114.82 |
Quartz Setting Professional Modifier None Typical Low $58.88 Median $107.15 Typical High $134.90 | Professional | None | $58.88 | $107.15 | $134.90 |
Quartz Setting Facility Modifier None Typical Low $144.54 Median $331.13 Typical High $331.13 | Facility | None | $144.54 | $331.13 | $331.13 |
Quartz Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | None | $109.65 | $109.65 | $120.23 |
Security Health Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $89.13 | Professional | None | $60.26 | $72.44 | $89.13 |
United Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $165.96 | Professional | None | $97.72 | $117.49 | $165.96 |
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 $51.29 Median $51.29 Typical High $123.03 | Professional | 52 · Reduced service | $51.29 | $51.29 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $48.98 | Professional | 53 · Discontinued | $20.42 | $20.42 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $37.15 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $24.55 |
Where Wisconsin sits
The same service costs 3.6 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· 27th of 51
$107
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.