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 $12.02 | Professional | None | $1.35 | $1.35 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $3.72 Typical High $12.59 | Professional | None | $1.95 | $3.72 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $6.17 Typical High $9.12 | Facility | None | $5.37 | $6.17 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $0.87 Median $1.70 Typical High $3.72 | Professional | None | $0.87 | $1.70 | $3.72 |
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 $7.59 Typical High $7.94 | Professional | None | $2.24 | $7.59 | $7.94 |
Medica Setting Facility Modifier None Typical Low $1.17 Median $2.24 Typical High $89.13 | Facility | None | $1.17 | $2.24 | $89.13 |
Medica Setting Professional Modifier None Typical Low $1.17 Median $1.62 Typical High $17.78 | Professional | None | $1.17 | $1.62 | $17.78 |
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 $4.07 Typical High $5.37 | Professional | None | $2.24 | $4.07 | $5.37 |
Quartz Setting Professional Modifier None Typical Low $0.87 Median $1.70 Typical High $1.70 | Professional | None | $0.87 | $1.70 | $1.70 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.23 Typical High $2.40 | Professional | None | $0.81 | $1.23 | $2.40 |
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 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $1.82 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $1.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.17 Median $6.61 Typical High $6.61 | Professional | UE · Used equipment | $4.17 | $6.61 | $6.61 |
Where Wisconsin sits
The same service costs 6.6 times more in Kentucky than in West Virginia. 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
$2.04
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.