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 $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $57.54 | Professional | None | $18.20 | $18.20 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $28.18 Typical High $42.66 | Facility | None | $25.70 | $28.18 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $28.84 | Professional | None | $23.99 | $23.99 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $79.43 Typical High $120.23 | Facility | None | $70.79 | $79.43 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $29.51 Typical High $42.66 | Professional | None | $15.14 | $29.51 | $42.66 |
DeanCare Setting Facility Modifier None Typical Low $15.49 Median $25.12 Typical High $26.30 | Facility | None | $15.49 | $25.12 | $26.30 |
DeanCare Setting Professional Modifier None Typical Low $22.39 Median $25.12 Typical High $27.54 | Professional | None | $22.39 | $25.12 | $27.54 |
Medica Setting Facility Modifier None Typical Low $15.49 Median $25.12 Typical High $51.29 | Facility | None | $15.49 | $25.12 | $51.29 |
Medica Setting Professional Modifier None Typical Low $11.75 Median $17.78 Typical High $125.89 | Professional | None | $11.75 | $17.78 | $125.89 |
Network Health Setting Professional Modifier None Typical Low $22.91 Median $33.88 Typical High $63.10 | Professional | None | $22.91 | $33.88 | $63.10 |
Prevea360 Setting Facility Modifier None Typical Low $15.49 Median $25.12 Typical High $26.30 | Facility | None | $15.49 | $25.12 | $26.30 |
Prevea360 Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Quartz Setting Professional Modifier None Typical Low $27.54 Median $38.90 Typical High $63.10 | Professional | None | $27.54 | $38.90 | $63.10 |
Quartz Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Security Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Security Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $33.88 | Professional | None | $25.70 | $25.70 | $33.88 |
United Setting Professional Modifier None Typical Low $9.77 Median $13.18 Typical High $22.91 | Professional | None | $9.77 | $13.18 | $22.91 |
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 $9.12 Median $9.12 Typical High $28.84 | Professional | 52 · Reduced service | $9.12 | $9.12 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $11.48 | Professional | 53 · Discontinued | $3.63 | $3.63 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $8.71 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $5.75 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $5.75 |
Where Wisconsin sits
The same service costs 2.6 times more in Hawaii than in Kentucky. 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· 9th of 51
$23.99
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.