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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $323.59 | Professional | None | $66.07 | $66.07 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $128.82 Typical High $144.54 | Facility | None | $120.23 | $128.82 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $66.07 Typical High $107.15 | Professional | None | $64.57 | $66.07 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $181.97 Typical High $218.78 | Facility | None | $109.65 | $181.97 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $120.23 Typical High $169.82 | Professional | None | $72.44 | $120.23 | $169.82 |
DeanCare Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $162.18 | Facility | None | $74.13 | $74.13 | $162.18 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $162.18 | Facility | None | $74.13 | $74.13 | $162.18 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $125.89 | Professional | None | $74.13 | $83.18 | $125.89 |
Network Health Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Prevea360 Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $162.18 | Facility | None | $74.13 | $74.13 | $162.18 |
Quartz Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $223.87 | Professional | None | $97.72 | $173.78 | $223.87 |
Quartz Setting Facility Modifier None Typical Low $95.50 Median $218.78 Typical High $218.78 | Facility | None | $95.50 | $218.78 | $218.78 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Security Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $123.03 | Professional | None | $100.00 | $100.00 | $123.03 |
United Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $125.89 | Professional | None | $74.13 | $83.18 | $125.89 |
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 $33.11 Median $33.11 Typical High $162.18 | Professional | 52 · Reduced service | $33.11 | $33.11 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $66.07 | Professional | 53 · Discontinued | $13.18 | $13.18 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $48.98 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $32.36 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $32.36 |
Where Wisconsin sits
The same service costs 2.8 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· 23rd of 51
$77.62
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.