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 $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $22.91 | Professional | None | $6.17 | $6.17 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.92 Median $7.59 Typical High $11.22 | Facility | None | $6.92 | $7.59 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $8.51 | Professional | None | $6.46 | $6.46 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $21.38 Typical High $32.36 | Facility | None | $19.05 | $21.38 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $5.75 Median $9.77 Typical High $12.88 | Professional | None | $5.75 | $9.77 | $12.88 |
DeanCare Setting Facility Modifier None Typical Low $4.90 Median $5.50 Typical High $7.08 | Facility | None | $4.90 | $5.50 | $7.08 |
DeanCare Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
Medica Setting Facility Modifier None Typical Low $4.90 Median $6.76 Typical High $234.42 | Facility | None | $4.90 | $6.76 | $234.42 |
Medica Setting Professional Modifier None Typical Low $3.39 Median $8.32 Typical High $24.55 | Professional | None | $3.39 | $8.32 | $24.55 |
Network Health Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Network Health Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Prevea360 Setting Facility Modifier None Typical Low $4.90 Median $5.50 Typical High $7.08 | Facility | None | $4.90 | $5.50 | $7.08 |
Prevea360 Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
Quartz Setting Professional Modifier None Typical Low $7.41 Median $10.72 Typical High $16.98 | Professional | None | $7.41 | $10.72 | $16.98 |
Quartz Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Security Health Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Security Health Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.91 | Professional | None | $6.92 | $6.92 | $8.91 |
United Setting Professional Modifier None Typical Low $2.63 Median $6.92 Typical High $24.55 | Professional | None | $2.63 | $6.92 | $24.55 |
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 $0.93 Median $0.93 Typical High $3.47 | Professional | 55 · Aftercare only | $0.93 | $0.93 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $2.29 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $2.29 |
Where Wisconsin sits
The same service costs 83.2 times more in Kansas than in Indiana. 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· 5th of 51
$6.92
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.