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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $100.00 | Professional | None | $51.29 | $51.29 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $74.13 | Professional | None | $46.77 | $48.98 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $102.33 Typical High $162.18 | Facility | None | $70.79 | $102.33 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $75.86 | Professional | None | $44.67 | $52.48 | $75.86 |
DeanCare Setting Facility Modifier None Typical Low $26.92 Median $47.86 Typical High $53.70 | Facility | None | $26.92 | $47.86 | $53.70 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $47.86 Typical High $53.70 | Facility | None | $26.92 | $47.86 | $53.70 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $77.62 | Professional | None | $44.67 | $53.70 | $77.62 |
Network Health Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Prevea360 Setting Facility Modifier None Typical Low $26.92 Median $47.86 Typical High $53.70 | Facility | None | $26.92 | $47.86 | $53.70 |
Quartz Setting Professional Modifier None Typical Low $33.88 Median $60.26 Typical High $75.86 | Professional | None | $33.88 | $60.26 | $75.86 |
Quartz Setting Facility Modifier None Typical Low $70.79 Median $162.18 Typical High $162.18 | Facility | None | $70.79 | $162.18 | $162.18 |
Quartz Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $97.72 | Professional | None | $53.70 | $53.70 | $97.72 |
Security Health Setting Professional Modifier None Typical Low $34.67 Median $41.69 Typical High $51.29 | Professional | None | $34.67 | $41.69 | $51.29 |
United Setting Professional Modifier None Typical Low $46.77 Median $57.54 Typical High $79.43 | Professional | None | $46.77 | $57.54 | $79.43 |
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 $25.70 Median $25.70 Typical High $48.98 | Professional | 52 · Reduced service | $25.70 | $25.70 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $19.95 | Professional | 53 · Discontinued | $10.23 | $10.23 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $14.79 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $10.00 |
Where Wisconsin sits
The same service costs 1.5 times more in Colorado than in Alaska. 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· 22nd of 51
$53.70
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.