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 $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $15.85 | Professional | None | $13.18 | $13.18 | $15.85 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $37.15 | Professional | None | $12.59 | $12.59 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $42.66 Typical High $64.57 | Facility | None | $38.02 | $42.66 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $27.54 | Professional | None | $10.23 | $10.23 | $27.54 |
DeanCare Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $29.51 | Facility | None | $12.88 | $16.22 | $29.51 |
DeanCare Setting Professional Modifier None Typical Low $25.12 Median $30.90 Typical High $38.90 | Professional | None | $25.12 | $30.90 | $38.90 |
Medica Setting Facility Modifier None Typical Low $12.88 Median $18.20 Typical High $100.00 | Facility | None | $12.88 | $18.20 | $100.00 |
Medica Setting Professional Modifier None Typical Low $12.88 Median $19.50 Typical High $1,905.46 | Professional | None | $12.88 | $19.50 | $1,905.46 |
Network Health Setting Professional Modifier None Typical Low $26.92 Median $70.79 Typical High $77.62 | Professional | None | $26.92 | $70.79 | $77.62 |
Prevea360 Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $29.51 | Facility | None | $12.88 | $16.22 | $29.51 |
Quartz Setting Professional Modifier None Typical Low $14.79 Median $16.22 Typical High $33.88 | Professional | None | $14.79 | $16.22 | $33.88 |
Quartz Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $27.54 | Professional | None | $10.23 | $10.23 | $27.54 |
Security Health Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $20.42 | Professional | None | $16.98 | $16.98 | $20.42 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $13.49 Median $14.79 Typical High $83.18 | Professional | None | $13.49 | $14.79 | $83.18 |
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 $6.61 Median $6.61 Typical High $7.94 | Professional | 52 · Reduced service | $6.61 | $6.61 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $3.16 | Professional | 53 · Discontinued | $2.63 | $2.63 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.40 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.58 |
Where Wisconsin sits
The same service costs 43.7 times more in Hawaii than in Florida. 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· 35th of 51
$14.13
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.