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 $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $40.74 | Professional | None | $4.68 | $4.68 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.25 Median $5.75 Typical High $8.71 | Facility | None | $5.25 | $5.75 | $8.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $7.08 | Professional | None | $4.90 | $4.90 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $16.22 Typical High $24.55 | Facility | None | $14.45 | $16.22 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $6.17 Typical High $9.77 | Professional | None | $2.57 | $6.17 | $9.77 |
DeanCare Setting Facility Modifier None Typical Low $4.07 Median $4.68 Typical High $5.37 | Facility | None | $4.07 | $4.68 | $5.37 |
DeanCare Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Medica Setting Facility Modifier None Typical Low $4.07 Median $5.13 Typical High $85.11 | Facility | None | $4.07 | $5.13 | $85.11 |
Medica Setting Professional Modifier None Typical Low $3.16 Median $10.47 Typical High $29.51 | Professional | None | $3.16 | $10.47 | $29.51 |
Network Health Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Prevea360 Setting Facility Modifier None Typical Low $4.07 Median $4.68 Typical High $5.37 | Facility | None | $4.07 | $4.68 | $5.37 |
Prevea360 Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Quartz Setting Professional Modifier None Typical Low $5.50 Median $7.94 Typical High $12.88 | Professional | None | $5.50 | $7.94 | $12.88 |
Quartz Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Security Health Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Security Health Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
Security Health Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $10.72 | Professional | None | $8.13 | $8.13 | $10.72 |
United Setting Professional Modifier None Typical Low $2.19 Median $10.23 Typical High $29.51 | Professional | None | $2.19 | $10.23 | $29.51 |
2 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 55 · Aftercare only Typical Low $0.71 Median $0.71 Typical High $6.17 | Professional | 55 · Aftercare only | $0.71 | $0.71 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.47 Typical High $4.07 | Professional | 56 · Pre-op care only | $0.47 | $0.47 | $4.07 |
Where Wisconsin sits
The same service costs 4.2 times more in Kansas than in Delaware. 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· 36th of 51
$5.25
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.