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 $0.12 Median $0.12 Typical High $0.12 | Facility | None | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $15.14 | Professional | None | $0.12 | $0.12 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.06 Typical High $7.59 | Professional | 52 · Reduced service | $0.06 | $0.06 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $3.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $2.24 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $2.24 |
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 $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
DeanCare Setting Facility Modifier None Typical Low $0.12 Median $0.12 Typical High $0.12 | Facility | None | $0.12 | $0.12 | $0.12 |
Medica Setting Facility Modifier None Typical Low $0.12 Median $89.13 Typical High $89.13 | Facility | None | $0.12 | $89.13 | $89.13 |
Medica Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Prevea360 Setting Facility Modifier None Typical Low $0.12 Median $0.12 Typical High $0.12 | Facility | None | $0.12 | $0.12 | $0.12 |
Quartz Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
1 more rate 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 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 660.7 times more in Montana than in Louisiana. 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· 13th of 51
$0.35
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.