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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $67.61 | Professional | None | $33.11 | $33.11 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $37.15 Median $40.74 Typical High $61.66 | Facility | None | $37.15 | $40.74 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $46.77 | Professional | None | $34.67 | $34.67 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $114.82 Typical High $169.82 | Facility | None | $100.00 | $114.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $43.65 Typical High $70.79 | Professional | None | $21.38 | $43.65 | $70.79 |
DeanCare Setting Facility Modifier None Typical Low $26.30 Median $30.20 Typical High $38.02 | Facility | None | $26.30 | $30.20 | $38.02 |
DeanCare Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $36.31 Typical High $169.82 | Facility | None | $26.30 | $36.31 | $169.82 |
Medica Setting Professional Modifier None Typical Low $18.20 Median $44.67 Typical High $131.83 | Professional | None | $18.20 | $44.67 | $131.83 |
Network Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Prevea360 Setting Facility Modifier None Typical Low $26.30 Median $30.20 Typical High $38.02 | Facility | None | $26.30 | $30.20 | $38.02 |
Prevea360 Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Quartz Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $91.20 | Professional | None | $39.81 | $57.54 | $91.20 |
Quartz Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Security Health Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Security Health Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Security Health Setting Professional Modifier None Typical Low $32.36 Median $37.15 Typical High $47.86 | Professional | None | $32.36 | $37.15 | $47.86 |
United Setting Professional Modifier None Typical Low $14.13 Median $37.15 Typical High $131.83 | Professional | None | $14.13 | $37.15 | $131.83 |
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 $5.01 Median $5.01 Typical High $10.00 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $6.76 |
Where Wisconsin sits
The same service costs 3.5 times more in Montana 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· 7th of 51
$37.15
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.