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 $81.28 Median $91.20 Typical High $107.15 | Facility | None | $81.28 | $91.20 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $154.88 | Professional | None | $81.28 | $104.71 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $331.13 Typical High $416.87 | Professional | None | $123.03 | $331.13 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $380.19 Typical High $562.34 | Facility | None | $331.13 | $380.19 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $363.08 | Professional | None | $109.65 | $208.93 | $363.08 |
DeanCare Setting Facility Modifier None Typical Low $81.28 Median $117.49 Typical High $199.53 | Facility | None | $81.28 | $117.49 | $199.53 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $141.25 Typical High $575.44 | Facility | None | $83.18 | $141.25 | $575.44 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $407.38 | Professional | None | $117.49 | $194.98 | $407.38 |
Network Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $251.19 | Facility | None | $190.55 | $190.55 | $251.19 |
Network Health Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $234.42 | Professional | None | $112.20 | $186.21 | $234.42 |
Prevea360 Setting Facility Modifier None Typical Low $81.28 Median $117.49 Typical High $199.53 | Facility | None | $81.28 | $117.49 | $199.53 |
Quartz Setting Professional Modifier None Typical Low $147.91 Median $295.12 Typical High $380.19 | Professional | None | $147.91 | $295.12 | $380.19 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | None | $141.25 | $141.25 | $169.82 |
Security Health Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $263.03 | Professional | None | $131.83 | $199.53 | $263.03 |
United Setting Professional Modifier None Typical Low $125.89 Median $275.42 Typical High $467.74 | Professional | None | $125.89 | $275.42 | $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 $53.70 Median $53.70 Typical High $181.97 | Professional | 52 · Reduced service | $53.70 | $53.70 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $54.95 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $36.31 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $36.31 |
Where Wisconsin sits
The same service costs 2.1 times more in Wisconsin 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· 1st of 51
$209
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.