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 $0.42 Median $0.42 Typical High $0.42 | Facility | None | $0.42 | $0.42 | $0.42 |
Aetna Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $7.94 | Professional | None | $0.42 | $0.42 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.48 Median $0.52 Typical High $0.79 | Facility | None | $0.48 | $0.52 | $0.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.65 | Professional | None | $0.45 | $0.45 | $0.65 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $1.02 Typical High $1.51 | Facility | None | $0.89 | $1.02 | $1.51 |
Cigna Setting Professional Modifier None Typical Low $0.33 Median $0.47 Typical High $0.89 | Professional | None | $0.33 | $0.47 | $0.89 |
DeanCare Setting Facility Modifier None Typical Low $0.37 Median $0.46 Typical High $0.76 | Facility | None | $0.37 | $0.46 | $0.76 |
DeanCare Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Medica Setting Facility Modifier None Typical Low $0.37 Median $0.46 Typical High $89.13 | Facility | None | $0.37 | $0.46 | $89.13 |
Medica Setting Professional Modifier None Typical Low $0.28 Median $0.93 Typical High $2.51 | Professional | None | $0.28 | $0.93 | $2.51 |
Network Health Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
Network Health Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Prevea360 Setting Facility Modifier None Typical Low $0.37 Median $0.46 Typical High $0.76 | Facility | None | $0.37 | $0.46 | $0.76 |
Prevea360 Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Quartz Setting Professional Modifier None Typical Low $0.37 Median $0.54 Typical High $0.91 | Professional | None | $0.37 | $0.54 | $0.91 |
Quartz Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | None | $0.33 | $0.33 | $0.33 |
Security Health Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
Security Health Setting Facility Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Facility | None | $0.89 | $0.89 | $0.89 |
Security Health Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.91 | Professional | None | $0.71 | $0.71 | $0.91 |
United Setting Professional Modifier None Typical Low $0.19 Median $0.85 Typical High $2.51 | Professional | None | $0.19 | $0.85 | $2.51 |
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 $0.06 Median $0.06 Typical High $1.20 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.79 |
Where Wisconsin sits
The same service costs 3.0 times more in Florida 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
$0.48
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.