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 $83.18 Median $93.33 Typical High $112.20 | Facility | None | $83.18 | $93.33 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $316.23 | Professional | None | $83.18 | $97.72 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $338.84 | Professional | None | $125.89 | $199.53 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $389.05 Typical High $588.84 | Facility | None | $346.74 | $389.05 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $309.03 Typical High $371.54 | Professional | None | $144.54 | $309.03 | $371.54 |
DeanCare Setting Facility Modifier None Typical Low $57.54 Median $120.23 Typical High $208.93 | Facility | None | $57.54 | $120.23 | $208.93 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $120.23 Typical High $208.93 | Facility | None | $57.54 | $120.23 | $208.93 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $269.15 | Professional | None | $117.49 | $213.80 | $269.15 |
Network Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Facility | None | $154.88 | $154.88 | $208.93 |
Prevea360 Setting Facility Modifier None Typical Low $57.54 Median $120.23 Typical High $208.93 | Facility | None | $57.54 | $120.23 | $208.93 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $389.05 | Professional | None | $131.83 | $213.80 | $389.05 |
Quartz Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $263.03 | Professional | None | $144.54 | $144.54 | $263.03 |
Security Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Security Health Setting Professional Modifier None Typical Low $177.83 Median $371.54 Typical High $407.38 | Professional | None | $177.83 | $371.54 | $407.38 |
United Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $288.40 | Professional | None | $117.49 | $218.78 | $288.40 |
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 $54.95 Median $54.95 Typical High $208.93 | Professional | 52 · Reduced service | $54.95 | $54.95 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $63.10 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $41.69 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $41.69 |
Where Wisconsin sits
The same service costs 2.9 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
$186
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.