How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $2.88 Median $2.88 Typical High $2.88 | Facility | None | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $41.69 | Professional | None | $2.88 | $2.88 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $10.72 Typical High $23.44 | Professional | None | $4.27 | $10.72 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $11.22 | Facility | None | $5.75 | $5.75 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $5.37 Typical High $9.12 | Professional | None | $3.72 | $5.37 | $9.12 |
DeanCare Setting Facility Modifier None Typical Low $3.55 Median $4.79 Typical High $9.33 | Facility | None | $3.55 | $4.79 | $9.33 |
DeanCare Setting Professional Modifier None Typical Low $4.79 Median $36.31 Typical High $38.90 | Professional | None | $4.79 | $36.31 | $38.90 |
Medica Setting Facility Modifier None Typical Low $3.55 Median $4.79 Typical High $9.33 | Facility | None | $3.55 | $4.79 | $9.33 |
Medica Setting Professional Modifier None Typical Low $2.63 Median $4.47 Typical High $10.23 | Professional | None | $2.63 | $4.47 | $10.23 |
Network Health Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
Network Health Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Prevea360 Setting Facility Modifier None Typical Low $3.55 Median $4.79 Typical High $9.33 | Facility | None | $3.55 | $4.79 | $9.33 |
Quartz Setting Professional Modifier None Typical Low $4.79 Median $9.55 Typical High $13.80 | Professional | None | $4.79 | $9.55 | $13.80 |
Quartz Setting Facility Modifier None Typical Low $4.90 Median $11.22 Typical High $11.22 | Facility | None | $4.90 | $11.22 | $11.22 |
Quartz Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $6.46 | Professional | None | $3.72 | $3.72 | $6.46 |
United Setting Professional Modifier None Typical Low $1.78 Median $3.55 Typical High $7.59 | Professional | None | $1.78 | $3.55 | $7.59 |
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 $1.45 Median $1.45 Typical High $20.89 | Professional | 52 · Reduced service | $1.45 | $1.45 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $8.32 | Professional | 53 · Discontinued | $0.58 | $0.58 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $6.31 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $4.17 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $4.17 |
Where Wisconsin sits
The same service costs 4.6 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· 8th of 51
$5.75
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.