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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $169.82 | Professional | None | $77.62 | $77.62 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $141.25 | Facility | None | $85.11 | $93.33 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $263.03 Typical High $398.11 | Facility | None | $234.42 | $263.03 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $0.09 Median $100.00 Typical High $162.18 | Professional | None | $0.09 | $100.00 | $162.18 |
DeanCare Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $87.10 | Facility | None | $61.66 | $69.18 | $87.10 |
DeanCare Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $83.18 Typical High $389.05 | Facility | None | $61.66 | $83.18 | $389.05 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $102.33 Typical High $302.00 | Professional | None | $41.69 | $102.33 | $302.00 |
Network Health Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Network Health Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Prevea360 Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $87.10 | Facility | None | $61.66 | $69.18 | $87.10 |
Prevea360 Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Quartz Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $213.80 | Professional | None | $91.20 | $131.83 | $213.80 |
Quartz Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | None | $0.09 | $0.09 | $0.09 |
Security Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Security Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $109.65 | Professional | None | $85.11 | $85.11 | $109.65 |
United Setting Professional Modifier None Typical Low $32.36 Median $85.11 Typical High $302.00 | Professional | None | $32.36 | $85.11 | $302.00 |
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 $11.48 Median $11.48 Typical High $25.12 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $16.98 |
Where Wisconsin sits
The same service costs 5.5 times more in Iowa than in Kansas. 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· 3rd of 51
$85.11
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.