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 $245.47 Median $245.47 Typical High $549.54 | Facility | None | $245.47 | $245.47 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $912.01 | Professional | None | $245.47 | $245.47 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $575.44 | Facility | None | $478.63 | $524.81 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $288.40 Typical High $812.83 | Facility | None | $204.17 | $288.40 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $316.23 | Professional | None | $257.04 | $269.15 | $316.23 |
DeanCare Setting Facility Modifier None Typical Low $245.47 Median $794.33 Typical High $1,174.90 | Facility | None | $245.47 | $794.33 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $1,202.26 Typical High $1,202.26 | Facility | None | $234.42 | $1,202.26 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $1,047.13 | Professional | None | $251.19 | $251.19 | $1,047.13 |
Network Health Setting Facility Modifier None Typical Low $239.88 Median $245.47 Typical High $245.47 | Facility | None | $239.88 | $245.47 | $245.47 |
Network Health Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $537.03 | Professional | None | $239.88 | $426.58 | $537.03 |
Prevea360 Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $295.12 | Facility | None | $239.88 | $239.88 | $295.12 |
Quartz Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Quartz Setting Facility Modifier None Typical Low $446.68 Median $812.83 Typical High $812.83 | Facility | None | $446.68 | $812.83 | $812.83 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
United Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $346.74 | Professional | None | $257.04 | $257.04 | $346.74 |
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 $123.03 Median $123.03 Typical High $446.68 | Professional | 52 · Reduced service | $123.03 | $123.03 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $181.97 | Professional | 53 · Discontinued | $48.98 | $48.98 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $134.90 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $91.20 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $91.20 |
Where Wisconsin sits
The same service costs 1.7 times more in Alaska than in Indiana. 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· 30th of 51
$263
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.