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 $18.62 Median $1,905.46 Typical High $14,454.40 | Facility | None | $18.62 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $229.09 | Professional | None | $18.62 | $18.62 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $46.77 Typical High $66.07 | Professional | None | $19.50 | $46.77 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $54.95 Typical High $83.18 | Facility | None | $48.98 | $54.95 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $47.86 Typical High $53.70 | Professional | None | $19.95 | $47.86 | $53.70 |
DeanCare Setting Facility Modifier None Typical Low $16.60 Median $21.38 Typical High $38.02 | Facility | None | $16.60 | $21.38 | $38.02 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $38.02 Typical High $117.49 | Facility | None | $19.95 | $38.02 | $117.49 |
Medica Setting Professional Modifier None Typical Low $26.30 Median $57.54 Typical High $74.13 | Professional | None | $26.30 | $57.54 | $74.13 |
Network Health Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Prevea360 Setting Facility Modifier None Typical Low $16.60 Median $21.38 Typical High $38.02 | Facility | None | $16.60 | $21.38 | $38.02 |
Quartz Setting Professional Modifier None Typical Low $20.89 Median $44.67 Typical High $81.28 | Professional | None | $20.89 | $44.67 | $81.28 |
Quartz Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $33.88 | Professional | None | $19.95 | $19.95 | $33.88 |
Security Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Security Health Setting Professional Modifier None Typical Low $28.84 Median $37.15 Typical High $69.18 | Professional | None | $28.84 | $37.15 | $69.18 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $20.42 Median $57.54 Typical High $85.11 | Professional | None | $20.42 | $57.54 | $85.11 |
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 $9.33 Median $9.33 Typical High $114.82 | Professional | 52 · Reduced service | $9.33 | $9.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $45.71 | Professional | 53 · Discontinued | $3.72 | $3.72 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $33.88 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $22.91 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $22.91 |
Where Wisconsin sits
The same service costs 40.7 times more in Tennessee 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· 10th of 51
$44.67
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.