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 $1.02 Median $1.02 Typical High $1.02 | Facility | None | $1.02 | $1.02 | $1.02 |
Aetna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $22.91 | Professional | None | $1.02 | $1.02 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.41 Median $1.55 Typical High $2.34 | Facility | None | $1.41 | $1.55 | $2.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.58 | Professional | None | $1.32 | $1.32 | $1.58 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $4.07 Typical High $6.17 | Facility | None | $3.63 | $4.07 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.51 Typical High $2.45 | Professional | None | $1.02 | $1.51 | $2.45 |
DeanCare Setting Facility Modifier None Typical Low $0.87 Median $1.41 Typical High $11.48 | Facility | None | $0.87 | $1.41 | $11.48 |
DeanCare Setting Professional Modifier None Typical Low $1.41 Median $20.89 Typical High $23.99 | Professional | None | $1.41 | $20.89 | $23.99 |
Medica Setting Facility Modifier None Typical Low $0.87 Median $1.41 Typical High $12.02 | Facility | None | $0.87 | $1.41 | $12.02 |
Medica Setting Professional Modifier None Typical Low $0.85 Median $1.62 Typical High $51.29 | Professional | None | $0.85 | $1.62 | $51.29 |
Network Health Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Network Health Setting Professional Modifier None Typical Low $1.51 Median $1.70 Typical High $7.59 | Professional | None | $1.51 | $1.70 | $7.59 |
Prevea360 Setting Facility Modifier None Typical Low $0.87 Median $1.41 Typical High $11.48 | Facility | None | $0.87 | $1.41 | $11.48 |
Prevea360 Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $9.55 | Professional | None | $1.41 | $1.41 | $9.55 |
Quartz Setting Professional Modifier None Typical Low $1.48 Median $2.14 Typical High $3.39 | Professional | None | $1.48 | $2.14 | $3.39 |
Quartz Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Security Health Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Security Health Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.86 | Professional | None | $1.41 | $1.41 | $1.86 |
United Setting Professional Modifier None Typical Low $0.56 Median $1.12 Typical High $9.12 | Professional | None | $0.56 | $1.12 | $9.12 |
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 $0.15 Median $0.15 Typical High $3.47 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $2.29 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $2.29 |
Security Health Setting Professional Modifier KL · Delivered by mail Typical Low $1.45 Median $1.45 Typical High $1.91 | Professional | KL · Delivered by mail | $1.45 | $1.45 | $1.91 |
Where Wisconsin sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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· 15th of 51
$1.41
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.