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 $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
Aetna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $5.01 | Professional | None | $1.41 | $1.41 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.00 Median $2.19 Typical High $3.31 | Facility | None | $2.00 | $2.19 | $3.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.24 | Professional | None | $1.86 | $1.86 | $2.24 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $6.17 Typical High $9.12 | Facility | None | $5.37 | $6.17 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $2.00 Typical High $3.31 | Professional | None | $1.00 | $2.00 | $3.31 |
DeanCare Setting Facility Modifier None Typical Low $1.12 Median $1.95 Typical High $2.04 | Facility | None | $1.12 | $1.95 | $2.04 |
DeanCare Setting Professional Modifier None Typical Low $1.78 Median $2.82 Typical High $3.47 | Professional | None | $1.78 | $2.82 | $3.47 |
Medica Setting Facility Modifier None Typical Low $1.12 Median $1.95 Typical High $3.98 | Facility | None | $1.12 | $1.95 | $3.98 |
Medica Setting Professional Modifier None Typical Low $0.91 Median $1.29 Typical High $9.77 | Professional | None | $0.91 | $1.29 | $9.77 |
Network Health Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
Network Health Setting Professional Modifier None Typical Low $1.74 Median $1.82 Typical High $3.31 | Professional | None | $1.74 | $1.82 | $3.31 |
Prevea360 Setting Facility Modifier None Typical Low $1.12 Median $1.95 Typical High $2.04 | Facility | None | $1.12 | $1.95 | $2.04 |
Prevea360 Setting Professional Modifier None Typical Low $1.12 Median $1.95 Typical High $1.95 | Professional | None | $1.12 | $1.95 | $1.95 |
Quartz Setting Professional Modifier None Typical Low $2.00 Median $3.02 Typical High $4.27 | Professional | None | $2.00 | $3.02 | $4.27 |
Quartz Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Security Health Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Security Health Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.57 | Professional | None | $2.00 | $2.00 | $2.57 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.98 Typical High $1.82 | Professional | None | $0.65 | $0.98 | $1.82 |
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 $0.71 Median $0.71 Typical High $2.51 | Professional | 52 · Reduced service | $0.71 | $0.71 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $1.00 | Professional | 53 · Discontinued | $0.28 | $0.28 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.76 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.50 |
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· 9th of 51
$1.86
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.