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 $40.74 Median $40.74 Typical High $46.77 | Facility | None | $40.74 | $40.74 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $77.62 | Professional | None | $40.74 | $40.74 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $46.77 Typical High $63.10 | Professional | None | $40.74 | $46.77 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $95.50 Typical High $158.49 | Facility | None | $67.61 | $95.50 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $102.33 | Professional | None | $51.29 | $51.29 | $102.33 |
DeanCare Setting Facility Modifier None Typical Low $20.89 Median $37.15 Typical High $41.69 | Facility | None | $20.89 | $37.15 | $41.69 |
DeanCare Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $125.89 | Facility | None | $36.31 | $36.31 | $125.89 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $48.98 Typical High $74.13 | Professional | None | $42.66 | $48.98 | $74.13 |
Network Health Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $41.69 | Facility | None | $32.36 | $32.36 | $41.69 |
Prevea360 Setting Facility Modifier None Typical Low $20.89 Median $37.15 Typical High $41.69 | Facility | None | $20.89 | $37.15 | $41.69 |
Prevea360 Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Quartz Setting Professional Modifier None Typical Low $40.74 Median $61.66 Typical High $95.50 | Professional | None | $40.74 | $61.66 | $95.50 |
Quartz Setting Facility Modifier None Typical Low $67.61 Median $158.49 Typical High $158.49 | Facility | None | $67.61 | $158.49 | $158.49 |
Quartz Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Security Health Setting Professional Modifier None Typical Low $26.30 Median $54.95 Typical High $67.61 | Professional | None | $26.30 | $54.95 | $67.61 |
United Setting Professional Modifier None Typical Low $45.71 Median $52.48 Typical High $79.43 | Professional | None | $45.71 | $52.48 | $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 $20.42 Median $20.42 Typical High $38.90 | Professional | 52 · Reduced service | $20.42 | $20.42 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $15.49 | Professional | 53 · Discontinued | $8.13 | $8.13 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $11.48 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $7.76 |
Where Wisconsin sits
The same service costs 6.0 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· 20th of 51
$50.12
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.