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 $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $10.96 | Professional | None | $3.47 | $3.47 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.90 Median $5.37 Typical High $7.94 | Facility | None | $4.90 | $5.37 | $7.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.50 | Professional | None | $4.47 | $4.47 | $5.50 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $15.49 Typical High $22.91 | Facility | None | $13.49 | $15.49 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $3.89 Typical High $8.13 | Professional | None | $2.00 | $3.89 | $8.13 |
DeanCare Setting Facility Modifier None Typical Low $2.75 Median $4.79 Typical High $5.01 | Facility | None | $2.75 | $4.79 | $5.01 |
DeanCare Setting Professional Modifier None Typical Low $4.37 Median $7.24 Typical High $8.51 | Professional | None | $4.37 | $7.24 | $8.51 |
Medica Setting Facility Modifier None Typical Low $2.75 Median $4.79 Typical High $9.55 | Facility | None | $2.75 | $4.79 | $9.55 |
Medica Setting Professional Modifier None Typical Low $2.19 Median $3.16 Typical High $23.44 | Professional | None | $2.19 | $3.16 | $23.44 |
Network Health Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Network Health Setting Professional Modifier None Typical Low $4.17 Median $4.47 Typical High $8.13 | Professional | None | $4.17 | $4.47 | $8.13 |
Prevea360 Setting Facility Modifier None Typical Low $2.75 Median $4.79 Typical High $5.01 | Facility | None | $2.75 | $4.79 | $5.01 |
Prevea360 Setting Professional Modifier None Typical Low $2.69 Median $4.79 Typical High $4.79 | Professional | None | $2.69 | $4.79 | $4.79 |
Quartz Setting Professional Modifier None Typical Low $4.47 Median $7.24 Typical High $10.23 | Professional | None | $4.47 | $7.24 | $10.23 |
Quartz Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Security Health Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Security Health Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $6.31 | Professional | None | $4.90 | $4.90 | $6.31 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.40 Typical High $4.37 | Professional | None | $1.58 | $2.40 | $4.37 |
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 $1.74 Median $1.74 Typical High $5.50 | Professional | 52 · Reduced service | $1.74 | $1.74 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.69 Typical High $2.19 | Professional | 53 · Discontinued | $0.69 | $0.69 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.51 Median $0.51 Typical High $1.66 | Professional | 55 · Aftercare only | $0.51 | $0.51 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $1.10 |
Where Wisconsin sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 10th of 51
$4.47
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.