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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $346.74 | Professional | None | $64.57 | $64.57 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $239.88 Typical High $537.03 | Professional | None | $95.50 | $239.88 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $269.15 Typical High $354.81 | Facility | None | $128.82 | $269.15 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $204.17 | Professional | None | $83.18 | $120.23 | $204.17 |
DeanCare Setting Facility Modifier None Typical Low $79.43 Median $109.65 Typical High $208.93 | Facility | None | $79.43 | $109.65 | $208.93 |
DeanCare Setting Professional Modifier None Typical Low $79.43 Median $426.58 Typical High $457.09 | Professional | None | $79.43 | $426.58 | $457.09 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $109.65 Typical High $208.93 | Facility | None | $79.43 | $109.65 | $208.93 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $60.26 Typical High $154.88 | Professional | None | $33.11 | $60.26 | $154.88 |
Network Health Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Network Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Prevea360 Setting Facility Modifier None Typical Low $79.43 Median $109.65 Typical High $208.93 | Facility | None | $79.43 | $109.65 | $208.93 |
Prevea360 Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $309.03 | Professional | None | $107.15 | $204.17 | $309.03 |
Quartz Setting Facility Modifier None Typical Low $109.65 Median $257.04 Typical High $257.04 | Facility | None | $109.65 | $257.04 | $257.04 |
Quartz Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $147.91 | Professional | None | $83.18 | $83.18 | $147.91 |
United Setting Professional Modifier None Typical Low $38.90 Median $60.26 Typical High $107.15 | Professional | None | $38.90 | $60.26 | $107.15 |
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 $32.36 Median $32.36 Typical High $173.78 | Professional | 52 · Reduced service | $32.36 | $32.36 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $69.18 | Professional | 53 · Discontinued | $12.88 | $12.88 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $52.48 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $34.67 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $34.67 |
Where Wisconsin sits
The same service costs 5.0 times more in Ohio 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· 3rd of 51
$129
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.