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 $0.56 Median $0.56 Typical High $0.56 | Facility | None | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $1.00 | Professional | None | $0.56 | $0.56 | $1.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.79 Median $0.87 Typical High $1.32 | Facility | None | $0.79 | $0.87 | $1.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.74 Median $0.74 Typical High $0.89 | Professional | None | $0.74 | $0.74 | $0.89 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $2.04 Typical High $3.09 | Facility | None | $1.82 | $2.04 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.76 Typical High $1.32 | Professional | None | $0.40 | $0.76 | $1.32 |
DeanCare Setting Facility Modifier None Typical Low $0.45 Median $0.78 Typical High $0.81 | Facility | None | $0.45 | $0.78 | $0.81 |
DeanCare Setting Professional Modifier None Typical Low $0.71 Median $0.98 Typical High $1.20 | Professional | None | $0.71 | $0.98 | $1.20 |
Medica Setting Facility Modifier None Typical Low $0.45 Median $0.78 Typical High $1.58 | Facility | None | $0.45 | $0.78 | $1.58 |
Medica Setting Professional Modifier None Typical Low $0.36 Median $0.52 Typical High $3.89 | Professional | None | $0.36 | $0.52 | $3.89 |
Network Health Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
Network Health Setting Professional Modifier None Typical Low $0.69 Median $0.72 Typical High $1.32 | Professional | None | $0.69 | $0.72 | $1.32 |
Prevea360 Setting Facility Modifier None Typical Low $0.45 Median $0.78 Typical High $0.81 | Facility | None | $0.45 | $0.78 | $0.81 |
Prevea360 Setting Professional Modifier None Typical Low $0.45 Median $0.78 Typical High $0.78 | Professional | None | $0.45 | $0.78 | $0.78 |
Quartz Setting Professional Modifier None Typical Low $0.79 Median $1.20 Typical High $1.70 | Professional | None | $0.79 | $1.20 | $1.70 |
Quartz Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Security Health Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Security Health Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.05 | Professional | None | $0.79 | $0.79 | $1.05 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.39 Typical High $0.72 | Professional | None | $0.26 | $0.39 | $0.72 |
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 $0.28 Median $0.28 Typical High $0.50 | Professional | 52 · Reduced service | $0.28 | $0.28 | $0.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.20 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.15 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.10 |
Where Wisconsin sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 10th of 51
$0.74
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.