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 $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $16.98 | Professional | None | $4.07 | $4.07 | $16.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $27.54 Median $30.20 Typical High $44.67 | Facility | None | $27.54 | $30.20 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $30.90 | Professional | None | $25.70 | $25.70 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $85.11 Typical High $125.89 | Facility | None | $74.13 | $85.11 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $26.92 Typical High $45.71 | Professional | None | $13.49 | $26.92 | $45.71 |
DeanCare Setting Facility Modifier None Typical Low $4.07 Median $26.92 Typical High $28.18 | Facility | None | $4.07 | $26.92 | $28.18 |
DeanCare Setting Professional Modifier None Typical Low $26.92 Median $28.18 Typical High $83.18 | Professional | None | $26.92 | $28.18 | $83.18 |
Medica Setting Facility Modifier None Typical Low $4.07 Median $26.92 Typical High $54.95 | Facility | None | $4.07 | $26.92 | $54.95 |
Medica Setting Professional Modifier None Typical Low $14.13 Median $18.62 Typical High $134.90 | Professional | None | $14.13 | $18.62 | $134.90 |
Network Health Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $74.13 | Professional | None | $29.51 | $42.66 | $74.13 |
Prevea360 Setting Facility Modifier None Typical Low $4.07 Median $26.92 Typical High $28.18 | Facility | None | $4.07 | $26.92 | $28.18 |
Prevea360 Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Quartz Setting Professional Modifier None Typical Low $25.12 Median $39.81 Typical High $57.54 | Professional | None | $25.12 | $39.81 | $57.54 |
Quartz Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Security Health Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Security Health Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $35.48 | Professional | None | $27.54 | $27.54 | $35.48 |
United Setting Professional Modifier None Typical Low $9.33 Median $14.13 Typical High $26.92 | Professional | None | $9.33 | $14.13 | $26.92 |
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 $2.04 Median $2.04 Typical High $8.51 | Professional | 52 · Reduced service | $2.04 | $2.04 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.81 Typical High $3.39 | Professional | 53 · Discontinued | $0.81 | $0.81 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $2.51 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $1.70 |
Where Wisconsin sits
The same service costs 6.9 times more in Montana than in Indiana. 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· 5th of 51
$25.70
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.