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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $741.31 | Professional | None | $239.88 | $239.88 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $288.40 Typical High $436.52 | Facility | None | $263.03 | $288.40 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | None | $245.47 | $245.47 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,230.27 | Facility | None | $724.44 | $812.83 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $309.03 Typical High $501.19 | Professional | None | $120.23 | $309.03 | $501.19 |
DeanCare Setting Facility Modifier None Typical Low $190.55 Median $213.80 Typical High $269.15 | Facility | None | $190.55 | $213.80 | $269.15 |
DeanCare Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $257.04 Typical High $1,202.26 | Facility | None | $190.55 | $257.04 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $316.23 Typical High $933.25 | Professional | None | $128.82 | $316.23 | $933.25 |
Network Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Prevea360 Setting Facility Modifier None Typical Low $190.55 Median $213.80 Typical High $269.15 | Facility | None | $190.55 | $213.80 | $269.15 |
Prevea360 Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Quartz Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $660.69 | Professional | None | $281.84 | $407.38 | $660.69 |
Quartz Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Security Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Security Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | None | $263.03 | $263.03 | $338.84 |
United Setting Professional Modifier None Typical Low $100.00 Median $263.03 Typical High $933.25 | Professional | None | $100.00 | $263.03 | $933.25 |
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 $35.48 Median $35.48 Typical High $112.20 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $74.13 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $74.13 |
Where Wisconsin sits
The same service costs 3.3 times more in Iowa than in New York. 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
$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.