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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $380.19 | Professional | None | $190.55 | $190.55 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $380.19 Typical High $426.58 | Facility | None | $354.81 | $380.19 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $295.12 | Professional | None | $173.78 | $173.78 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $288.40 Typical High $575.44 | Facility | None | $190.55 | $288.40 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $354.81 | Professional | None | $190.55 | $190.55 | $354.81 |
DeanCare Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $426.58 | Facility | None | $190.55 | $190.55 | $426.58 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $162.18 Typical High $354.81 | Facility | None | $151.36 | $162.18 | $354.81 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $281.84 | Professional | None | $162.18 | $181.97 | $281.84 |
Network Health Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Prevea360 Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $426.58 | Facility | None | $190.55 | $190.55 | $426.58 |
Quartz Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $537.03 | Professional | None | $190.55 | $309.03 | $537.03 |
Quartz Setting Facility Modifier None Typical Low $251.19 Median $575.44 Typical High $575.44 | Facility | None | $251.19 | $575.44 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Security Health Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $316.23 | Professional | None | $257.04 | $257.04 | $316.23 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
United Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $288.40 | Professional | None | $177.83 | $213.80 | $288.40 |
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 $95.50 Median $95.50 Typical High $190.55 | Professional | 52 · Reduced service | $95.50 | $95.50 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $75.86 | Professional | 53 · Discontinued | $38.02 | $38.02 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $57.54 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $38.02 |
Where Wisconsin sits
The same service costs 6.3 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· 25th of 51
$191
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.