How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.45 Median $0.45 Typical High $0.45 | Facility | None | $0.45 | $0.45 | $0.45 |
Aetna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $3.98 | Professional | None | $0.45 | $0.45 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.65 Median $1.07 Typical High $3.63 | Professional | None | $0.65 | $1.07 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $2.04 Typical High $3.09 | Facility | None | $1.82 | $2.04 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $1.82 Typical High $1.82 | Professional | None | $0.76 | $1.82 | $1.82 |
DeanCare Setting Facility Modifier None Typical Low $0.39 Median $0.74 Typical High $1.41 | Facility | None | $0.39 | $0.74 | $1.41 |
DeanCare Setting Professional Modifier None Typical Low $0.74 Median $3.16 Typical High $3.39 | Professional | None | $0.74 | $3.16 | $3.39 |
Medica Setting Facility Modifier None Typical Low $0.39 Median $0.74 Typical High $89.13 | Facility | None | $0.39 | $0.74 | $89.13 |
Medica Setting Professional Modifier None Typical Low $0.39 Median $0.54 Typical High $7.08 | Professional | None | $0.39 | $0.54 | $7.08 |
Network Health Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Prevea360 Setting Facility Modifier None Typical Low $0.39 Median $0.74 Typical High $1.41 | Facility | None | $0.39 | $0.74 | $1.41 |
Prevea360 Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Quartz Setting Professional Modifier None Typical Low $0.74 Median $1.35 Typical High $1.82 | Professional | None | $0.74 | $1.35 | $1.82 |
Quartz Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Security Health Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.23 | Professional | None | $1.05 | $1.05 | $1.23 |
United Setting Professional Modifier None Typical Low $0.27 Median $0.41 Typical High $0.79 | Professional | None | $0.27 | $0.41 | $0.79 |
2 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 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.60 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.40 |
Where Wisconsin sits
The same service costs 190.5 times more in Wyoming than in Rhode Island. 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· 20th of 51
$0.79
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.