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 $0.22 Median $0.22 Typical High $0.22 | Facility | None | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $1.00 | Professional | None | $0.22 | $0.22 | $1.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.32 Median $0.54 Typical High $1.82 | Professional | None | $0.32 | $0.54 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $11.22 Typical High $16.98 | Facility | None | $10.00 | $11.22 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $5.13 | Professional | None | $0.28 | $0.28 | $5.13 |
DeanCare Setting Facility Modifier None Typical Low $0.20 Median $0.37 Typical High $0.71 | Facility | None | $0.20 | $0.37 | $0.71 |
DeanCare Setting Professional Modifier None Typical Low $0.38 Median $0.43 Typical High $0.45 | Professional | None | $0.38 | $0.43 | $0.45 |
Medica Setting Facility Modifier None Typical Low $0.20 Median $0.37 Typical High $89.13 | Facility | None | $0.20 | $0.37 | $89.13 |
Medica Setting Professional Modifier None Typical Low $0.20 Median $0.27 Typical High $10.23 | Professional | None | $0.20 | $0.27 | $10.23 |
Network Health Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Prevea360 Setting Facility Modifier None Typical Low $0.20 Median $0.37 Typical High $0.71 | Facility | None | $0.20 | $0.37 | $0.71 |
Prevea360 Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Quartz Setting Professional Modifier None Typical Low $0.37 Median $0.68 Typical High $0.91 | Professional | None | $0.37 | $0.68 | $0.91 |
Quartz Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
United Setting Professional Modifier None Typical Low $0.14 Median $0.20 Typical High $0.39 | Professional | None | $0.14 | $0.20 | $0.39 |
2 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 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.15 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.10 |
Where Wisconsin sits
The same service costs 15.5 times more in Minnesota than in Hawaii. 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· 8th 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.