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 $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,905.46 | Professional | None | $851.14 | $851.14 | $1,905.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $5,248.07 | Professional | None | $107.15 | $190.55 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $389.05 Typical High $467.74 | Facility | None | $199.53 | $389.05 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | None | $125.89 | $125.89 | $181.97 |
DeanCare Setting Facility Modifier None Typical Low $64.57 Median $1,412.54 Typical High $2,691.53 | Facility | None | $64.57 | $1,412.54 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $1,412.54 Typical High $2,691.53 | Facility | None | $64.57 | $1,412.54 | $2,691.53 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $4,897.79 | Professional | None | $1,445.44 | $1,445.44 | $4,897.79 |
Network Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Prevea360 Setting Facility Modifier None Typical Low $64.57 Median $1,412.54 Typical High $2,691.53 | Facility | None | $64.57 | $1,412.54 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $331.13 | Professional | None | $141.25 | $199.53 | $331.13 |
Quartz Setting Facility Modifier None Typical Low $169.82 Median $389.05 Typical High $389.05 | Facility | None | $169.82 | $389.05 | $389.05 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Security Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Security Health Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $331.13 | Professional | None | $138.04 | $173.78 | $331.13 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
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 $426.58 Median $426.58 Typical High $954.99 | Professional | 52 · Reduced service | $426.58 | $426.58 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $380.19 | Professional | 53 · Discontinued | $169.82 | $169.82 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $281.84 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $190.55 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $190.55 |
Where Wisconsin sits
The same service costs 26.9 times more in Kansas 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· 8th of 51
$195
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.