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 $1.82 Median $1.82 Typical High $1.82 | Facility | None | $1.82 | $1.82 | $1.82 |
Aetna Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $3.98 | Professional | None | $1.82 | $1.82 | $3.98 |
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 $2.51 | Professional | None | $1.86 | $1.86 | $2.51 |
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 $1.17 Median $2.24 Typical High $3.80 | Professional | None | $1.17 | $2.24 | $3.80 |
DeanCare Setting Facility Modifier None Typical Low $1.58 Median $1.66 Typical High $2.04 | Facility | None | $1.58 | $1.66 | $2.04 |
DeanCare Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Medica Setting Facility Modifier None Typical Low $1.58 Median $1.95 Typical High $85.11 | Facility | None | $1.58 | $1.95 | $85.11 |
Medica Setting Professional Modifier None Typical Low $1.12 Median $3.63 Typical High $9.77 | Professional | None | $1.12 | $3.63 | $9.77 |
Network Health Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Network Health Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
Prevea360 Setting Facility Modifier None Typical Low $1.58 Median $1.66 Typical High $2.04 | Facility | None | $1.58 | $1.66 | $2.04 |
Prevea360 Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Quartz Setting Professional Modifier None Typical Low $2.24 Median $3.24 Typical High $5.13 | Professional | None | $2.24 | $3.24 | $5.13 |
Quartz Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.70 | Professional | None | $1.17 | $1.17 | $1.70 |
Security Health Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | None | $2.75 | $2.75 | $2.75 |
Security Health Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
Security Health Setting Professional Modifier None Typical Low $2.69 Median $2.75 Typical High $3.63 | Professional | None | $2.69 | $2.75 | $3.63 |
United Setting Professional Modifier None Typical Low $0.76 Median $3.24 Typical High $9.77 | Professional | None | $0.76 | $3.24 | $9.77 |
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 $0.27 Median $0.27 Typical High $0.60 | Professional | 55 · Aftercare only | $0.27 | $0.27 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.40 |
Where Wisconsin sits
The same service costs 33.1 times more in Kansas than in Alabama. 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· 26th of 51
$2.00
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.