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 $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $25.12 | Professional | None | $10.72 | $10.72 | $25.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.75 Median $12.88 Typical High $19.50 | Facility | None | $11.75 | $12.88 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $14.79 | Professional | None | $10.96 | $10.96 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $37.15 Typical High $54.95 | Facility | None | $32.36 | $37.15 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $13.80 Typical High $22.39 | Professional | None | $5.13 | $13.80 | $22.39 |
DeanCare Setting Facility Modifier None Typical Low $8.51 Median $9.55 Typical High $12.30 | Facility | None | $8.51 | $9.55 | $12.30 |
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 $8.51 Median $11.48 Typical High $85.11 | Facility | None | $8.51 | $11.48 | $85.11 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $14.45 Typical High $42.66 | Professional | None | $5.75 | $14.45 | $42.66 |
Network Health Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Network Health Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Prevea360 Setting Facility Modifier None Typical Low $8.51 Median $9.55 Typical High $12.30 | Facility | None | $8.51 | $9.55 | $12.30 |
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 $12.88 Median $18.62 Typical High $29.51 | Professional | None | $12.88 | $18.62 | $29.51 |
Quartz Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Security Health Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
Security Health Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Security Health Setting Professional Modifier None Typical Low $10.00 Median $11.75 Typical High $15.49 | Professional | None | $10.00 | $11.75 | $15.49 |
United Setting Professional Modifier None Typical Low $4.57 Median $11.75 Typical High $42.66 | Professional | None | $4.57 | $11.75 | $42.66 |
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 $1.58 Median $1.58 Typical High $3.72 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $2.51 |
Where Wisconsin sits
The same service costs 4.6 times more in Florida 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· 9th of 51
$11.75
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.