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 $1.78 Median $1.78 Typical High $1.78 | Facility | None | $1.78 | $1.78 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $12.02 | Professional | None | $1.78 | $1.78 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.51 Median $2.75 Typical High $4.17 | Facility | None | $2.51 | $2.75 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.82 | Professional | None | $2.34 | $2.34 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $7.24 Median $8.13 Typical High $12.30 | Facility | None | $7.24 | $8.13 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $4.17 | Professional | None | $1.02 | $1.12 | $4.17 |
DeanCare Setting Facility Modifier None Typical Low $1.41 Median $2.45 Typical High $2.57 | Facility | None | $1.41 | $2.45 | $2.57 |
DeanCare Setting Professional Modifier None Typical Low $2.24 Median $22.39 Typical High $25.70 | Professional | None | $2.24 | $22.39 | $25.70 |
Medica Setting Facility Modifier None Typical Low $1.41 Median $2.45 Typical High $5.01 | Facility | None | $1.41 | $2.45 | $5.01 |
Medica Setting Professional Modifier None Typical Low $1.15 Median $1.62 Typical High $12.30 | Professional | None | $1.15 | $1.62 | $12.30 |
Network Health Setting Professional Modifier None Typical Low $2.29 Median $3.24 Typical High $6.17 | Professional | None | $2.29 | $3.24 | $6.17 |
Prevea360 Setting Facility Modifier None Typical Low $1.41 Median $2.45 Typical High $2.57 | Facility | None | $1.41 | $2.45 | $2.57 |
Prevea360 Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
Quartz Setting Professional Modifier None Typical Low $2.51 Median $3.72 Typical High $5.13 | Professional | None | $2.51 | $3.72 | $5.13 |
Quartz Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
Security Health Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Security Health Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $3.24 | Professional | None | $2.51 | $2.51 | $3.24 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.23 Typical High $2.29 | Professional | None | $0.81 | $1.23 | $2.29 |
5 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 $0.87 Median $0.87 Typical High $6.03 | Professional | 52 · Reduced service | $0.87 | $0.87 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.35 Typical High $2.40 | Professional | 53 · Discontinued | $0.35 | $0.35 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.26 Typical High $1.82 | Professional | 55 · Aftercare only | $0.26 | $0.26 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $1.20 |
DeanCare Setting Professional Modifier AW · With surgical dressing Typical Low $2.24 Median $23.44 Typical High $25.70 | Professional | AW · With surgical dressing | $2.24 | $23.44 | $25.70 |
Where Wisconsin sits
The same service costs 4.6 times more in Rhode Island 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· 11th of 51
$2.34
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.