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 $1.35 Median $1.35 Typical High $1.35 | Facility | None | $1.35 | $1.35 | $1.35 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $10.00 | Professional | None | $1.35 | $1.35 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $3.72 Typical High $10.96 | Professional | None | $1.95 | $3.72 | $10.96 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $16.22 Typical High $24.55 | Facility | None | $14.45 | $16.22 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.98 Typical High $7.59 | Professional | None | $3.72 | $3.98 | $7.59 |
DeanCare Setting Facility Modifier None Typical Low $1.17 Median $2.24 Typical High $4.27 | Facility | None | $1.17 | $2.24 | $4.27 |
DeanCare Setting Professional Modifier None Typical Low $2.24 Median $2.57 Typical High $2.75 | Professional | None | $2.24 | $2.57 | $2.75 |
Medica Setting Facility Modifier None Typical Low $1.17 Median $2.24 Typical High $100.00 | Facility | None | $1.17 | $2.24 | $100.00 |
Medica Setting Professional Modifier None Typical Low $1.17 Median $1.62 Typical High $15.85 | Professional | None | $1.17 | $1.62 | $15.85 |
Network Health Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Prevea360 Setting Facility Modifier None Typical Low $1.17 Median $2.24 Typical High $4.27 | Facility | None | $1.17 | $2.24 | $4.27 |
Prevea360 Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Quartz Setting Professional Modifier None Typical Low $2.24 Median $3.80 Typical High $5.25 | Professional | None | $2.24 | $3.80 | $5.25 |
Quartz Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Security Health Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.91 | Professional | None | $1.62 | $1.62 | $1.91 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.23 Typical High $2.40 | Professional | None | $0.81 | $1.23 | $2.40 |
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 $0.20 Median $0.20 Typical High $1.51 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $1.00 |
Where Wisconsin sits
The same service costs 6.0 times more in Minnesota 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· 16th of 51
$2.40
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.