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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $616.60 | Professional | None | $263.03 | $263.03 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $288.40 | Professional | None | $158.49 | $263.03 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $467.74 Typical High $870.96 | Facility | None | $371.54 | $467.74 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $288.40 | Professional | None | $138.04 | $199.53 | $288.40 |
DeanCare Setting Facility Modifier None Typical Low $67.61 Median $123.03 Typical High $281.84 | Facility | None | $67.61 | $123.03 | $281.84 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $147.91 Typical High $380.19 | Facility | None | $67.61 | $147.91 | $380.19 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $407.38 | Professional | None | $234.42 | $281.84 | $407.38 |
Network Health Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Prevea360 Setting Facility Modifier None Typical Low $67.61 Median $123.03 Typical High $281.84 | Facility | None | $67.61 | $123.03 | $281.84 |
Quartz Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $229.09 | Professional | None | $100.00 | $181.97 | $229.09 |
Quartz Setting Facility Modifier None Typical Low $380.19 Median $870.96 Typical High $870.96 | Facility | None | $380.19 | $870.96 | $870.96 |
Quartz Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Security Health Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $144.54 | Professional | None | $97.72 | $117.49 | $144.54 |
United Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $446.68 | Professional | None | $257.04 | $309.03 | $446.68 |
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 $131.83 Median $131.83 Typical High $323.59 | Professional | 52 · Reduced service | $131.83 | $131.83 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $128.82 | Professional | 53 · Discontinued | $52.48 | $52.48 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $97.72 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $64.57 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $64.57 |
Where Wisconsin sits
The same service costs 3.9 times more in Arizona than in Montana. 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· 31st of 51
$263
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.