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 $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $131.83 | Professional | None | $22.39 | $22.39 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $54.95 Typical High $77.62 | Professional | None | $20.89 | $54.95 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $51.29 Typical High $75.86 | Facility | None | $44.67 | $51.29 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $53.70 Typical High $61.66 | Professional | None | $25.12 | $53.70 | $61.66 |
DeanCare Setting Facility Modifier None Typical Low $24.55 Median $26.30 Typical High $45.71 | Facility | None | $24.55 | $26.30 | $45.71 |
Medica Setting Facility Modifier None Typical Low $24.55 Median $26.30 Typical High $45.71 | Facility | None | $24.55 | $26.30 | $45.71 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $52.48 Typical High $66.07 | Professional | None | $21.88 | $52.48 | $66.07 |
Prevea360 Setting Facility Modifier None Typical Low $24.55 Median $26.30 Typical High $45.71 | Facility | None | $24.55 | $26.30 | $45.71 |
Quartz Setting Professional Modifier None Typical Low $23.99 Median $50.12 Typical High $69.18 | Professional | None | $23.99 | $50.12 | $69.18 |
Quartz Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $61.66 | Professional | None | $35.48 | $47.86 | $61.66 |
Security Health Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $69.18 | Professional | None | $41.69 | $41.69 | $69.18 |
United Setting Professional Modifier None Typical Low $21.88 Median $52.48 Typical High $66.07 | Professional | None | $21.88 | $52.48 | $66.07 |
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 $11.22 Median $11.22 Typical High $66.07 | Professional | 52 · Reduced service | $11.22 | $11.22 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $26.30 | Professional | 53 · Discontinued | $4.47 | $4.47 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $19.95 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $13.18 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $13.18 |
Where Wisconsin sits
The same service costs 4.3 times more in Alaska than in New York. 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· 2nd of 51
$51.29
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.