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 $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $295.12 | Professional | None | $281.84 | $288.40 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $2,398.83 | Professional | None | $436.52 | $707.95 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $2,041.74 | Facility | None | $1,202.26 | $1,348.96 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $724.44 | Professional | None | $371.54 | $371.54 | $724.44 |
DeanCare Setting Facility Modifier None Typical Low $354.81 Median $489.78 Typical High $933.25 | Facility | None | $354.81 | $489.78 | $933.25 |
DeanCare Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $489.78 | Professional | None | $407.38 | $457.09 | $489.78 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $489.78 Typical High $2,290.87 | Facility | None | $354.81 | $489.78 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $3,388.44 | Professional | None | $257.04 | $446.68 | $3,388.44 |
Network Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Prevea360 Setting Facility Modifier None Typical Low $354.81 Median $489.78 Typical High $933.25 | Facility | None | $354.81 | $489.78 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $489.78 Median $891.25 Typical High $1,258.93 | Professional | None | $489.78 | $891.25 | $1,258.93 |
Quartz Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $512.86 | Professional | None | $177.83 | $269.15 | $512.86 |
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 $138.04 Median $144.54 Typical High $147.91 | Professional | 52 · Reduced service | $138.04 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $56.23 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $41.69 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $29.51 |
Where Wisconsin sits
The same service costs 17.0 times more in Iowa than in Kentucky. 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· 12th of 51
$417
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.