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 $0.68 Median $0.68 Typical High $0.68 | Facility | None | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $2.00 | Professional | None | $0.68 | $0.68 | $2.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.98 Median $1.07 Typical High $1.58 | Facility | None | $0.98 | $1.07 | $1.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $1.07 | Professional | None | $0.89 | $0.89 | $1.07 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $3.09 Typical High $4.57 | Facility | None | $2.69 | $3.09 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $1.00 Typical High $1.62 | Professional | None | $0.49 | $1.00 | $1.62 |
DeanCare Setting Facility Modifier None Typical Low $0.56 Median $0.95 Typical High $1.00 | Facility | None | $0.56 | $0.95 | $1.00 |
DeanCare Setting Professional Modifier None Typical Low $0.87 Median $1.62 Typical High $2.00 | Professional | None | $0.87 | $1.62 | $2.00 |
Medica Setting Facility Modifier None Typical Low $0.56 Median $0.95 Typical High $1.95 | Facility | None | $0.56 | $0.95 | $1.95 |
Medica Setting Professional Modifier None Typical Low $0.44 Median $0.65 Typical High $4.68 | Professional | None | $0.44 | $0.65 | $4.68 |
Network Health Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
Network Health Setting Professional Modifier None Typical Low $0.85 Median $0.89 Typical High $1.62 | Professional | None | $0.85 | $0.89 | $1.62 |
Prevea360 Setting Facility Modifier None Typical Low $0.56 Median $0.95 Typical High $1.00 | Facility | None | $0.56 | $0.95 | $1.00 |
Prevea360 Setting Professional Modifier None Typical Low $0.54 Median $0.95 Typical High $0.95 | Professional | None | $0.54 | $0.95 | $0.95 |
Quartz Setting Professional Modifier None Typical Low $0.85 Median $1.41 Typical High $1.70 | Professional | None | $0.85 | $1.41 | $1.70 |
Quartz Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Security Health Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $0.98 | Professional | None | $0.98 | $0.98 | $0.98 |
Security Health Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $1.26 | Professional | None | $0.98 | $0.98 | $1.26 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.48 Typical High $0.89 | Professional | None | $0.32 | $0.48 | $0.89 |
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 $0.34 Median $0.34 Typical High $1.00 | Professional | 52 · Reduced service | $0.34 | $0.34 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.14 Median $0.14 Typical High $0.40 | Professional | 53 · Discontinued | $0.14 | $0.14 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.30 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.20 |
Where Wisconsin sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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
$0.89
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.