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 $0.04 Median $0.04 Typical High $0.04 | Facility | None | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier None Typical Low $0.04 Median $0.04 Typical High $15.14 | Professional | None | $0.04 | $0.04 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.02 Median $0.02 Typical High $7.59 | Professional | 52 · Reduced service | $0.02 | $0.02 | $7.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $43.65 Typical High $43.65 | Professional | None | $30.20 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
DeanCare Setting Facility Modifier None Typical Low $0.03 Median $0.03 Typical High $0.03 | Facility | None | $0.03 | $0.03 | $0.03 |
DeanCare Setting Professional Modifier None Typical Low $3.39 Median $3.80 Typical High $3.98 | Professional | None | $3.39 | $3.80 | $3.98 |
Medica Setting Facility Modifier None Typical Low $0.03 Median $89.13 Typical High $89.13 | Facility | None | $0.03 | $89.13 | $89.13 |
Medica Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Prevea360 Setting Facility Modifier None Typical Low $0.03 Median $0.03 Typical High $0.03 | Facility | None | $0.03 | $0.03 | $0.03 |
Quartz Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Security Health Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.78 | Professional | None | $1.51 | $1.51 | $1.78 |
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 53 · Discontinued Typical Low $2.82 Median $3.02 Typical High $3.24 | Professional | 53 · Discontinued | $2.82 | $3.02 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.24 Typical High $2.40 | Professional | 55 · Aftercare only | $2.09 | $2.24 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.51 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.41 | $1.51 | $1.58 |
Where Wisconsin sits
The same service costs 2630.3 times more in Montana than in Nevada. 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· 18th of 51
$0.31
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.