How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $2,754.23 | Professional | None | $870.96 | $870.96 | $2,754.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,862.09 Typical High $2,884.03 | Professional | None | $776.25 | $1,862.09 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $3,162.28 | Facility | None | $1,862.09 | $2,137.96 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,995.26 | Professional | None | $891.25 | $933.25 | $1,995.26 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,737.80 | Facility | None | $933.25 | $1,000.00 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,737.80 | Facility | None | $933.25 | $1,000.00 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,230.27 Typical High $5,370.32 | Professional | None | $616.60 | $1,230.27 | $5,370.32 |
Network Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,737.80 | $2,137.96 | $2,137.96 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,737.80 | Facility | None | $933.25 | $1,000.00 | $1,737.80 |
Quartz Setting Professional Modifier None Typical Low $954.99 Median $1,819.70 Typical High $2,691.53 | Professional | None | $954.99 | $1,819.70 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Professional | None | $933.25 | $933.25 | $1,096.48 |
United Setting Professional Modifier None Typical Low $524.81 Median $851.14 Typical High $1,862.09 | Professional | None | $524.81 | $851.14 | $1,862.09 |
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 $436.52 Median $436.52 Typical High $1,380.38 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $562.34 | Professional | 53 · Discontinued | $173.78 | $173.78 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $416.87 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $275.42 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $275.42 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska than in Arkansas. 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· 13th of 51
$1,000
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.