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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $194.98 | Professional | None | $51.29 | $85.11 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $2,951.21 Typical High $5,754.40 | Facility | None | $1,380.38 | $2,951.21 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $165.96 Typical High $302.00 | Professional | None | $45.71 | $165.96 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $112.20 | Facility | None | $75.86 | $95.50 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $85.11 Typical High $257.04 | Professional | None | $45.71 | $85.11 | $257.04 |
DeanCare Setting Facility Modifier None Typical Low $12.59 Median $91.20 Typical High $117.49 | Facility | None | $12.59 | $91.20 | $117.49 |
Medica Setting Facility Modifier None Typical Low $12.59 Median $173.78 Typical High $288.40 | Facility | None | $12.59 | $173.78 | $288.40 |
Medica Setting Professional Modifier None Typical Low $35.48 Median $79.43 Typical High $575.44 | Professional | None | $35.48 | $79.43 | $575.44 |
Network Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Prevea360 Setting Facility Modifier None Typical Low $12.59 Median $91.20 Typical High $117.49 | Facility | None | $12.59 | $91.20 | $117.49 |
Quartz Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $257.04 | Professional | None | $97.72 | $173.78 | $257.04 |
Quartz Setting Professional Modifier None Typical Low $33.88 Median $85.11 Typical High $147.91 | Professional | None | $33.88 | $85.11 | $147.91 |
Security Health Setting Professional Modifier None Typical Low $19.05 Median $112.20 Typical High $112.20 | Professional | None | $19.05 | $112.20 | $112.20 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $35.48 Median $79.43 Typical High $239.88 | Professional | None | $35.48 | $79.43 | $239.88 |
5 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 $42.66 Median $42.66 Typical High $100.00 | Professional | 52 · Reduced service | $42.66 | $42.66 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $39.81 | Professional | 53 · Discontinued | $17.38 | $17.38 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $147.91 | Professional | 54 · Surgery only | $64.57 | $64.57 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $29.51 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $19.95 |
Where Wisconsin sits
The same service costs 4.5 times more in Alaska than in Ohio. 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· 4th of 51
$123
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.