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 $107.15 Median $123.03 Typical High $144.54 | Facility | None | $107.15 | $123.03 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $794.33 | Professional | None | $107.15 | $144.54 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $346.74 Typical High $478.63 | Professional | None | $162.18 | $346.74 | $478.63 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $512.86 | Professional | None | $154.88 | $223.87 | $512.86 |
DeanCare Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $331.13 | Facility | None | $128.82 | $158.49 | $331.13 |
DeanCare Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $407.38 | Professional | None | $257.04 | $288.40 | $407.38 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $331.13 | Facility | None | $128.82 | $158.49 | $331.13 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $398.11 Typical High $1,000.00 | Professional | None | $181.97 | $398.11 | $1,000.00 |
Network Health Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $436.52 | Professional | None | $229.09 | $302.00 | $436.52 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $331.13 | Facility | None | $128.82 | $158.49 | $331.13 |
Quartz Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $436.52 | Professional | None | $151.36 | $316.23 | $436.52 |
Quartz Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $407.38 | Professional | None | $154.88 | $154.88 | $407.38 |
Security Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Security Health Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $489.78 | Professional | None | $302.00 | $426.58 | $489.78 |
The Alliance Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $457.09 | Professional | None | $194.98 | $346.74 | $457.09 |
United Setting Professional Modifier None Typical Low $162.18 Median $316.23 Typical High $467.74 | Professional | None | $162.18 | $316.23 | $467.74 |
3 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 $70.79 Median $70.79 Typical High $426.58 | Professional | 52 · Reduced service | $70.79 | $70.79 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $128.82 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $85.11 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $85.11 |
Where Wisconsin sits
The same service costs 2.4 times more in Alaska 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· 4th of 51
$269
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.