How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $169.82 Median $169.82 Typical High $14,454.40 | Facility | None | $169.82 | $169.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $831.76 | Professional | None | $169.82 | $169.82 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $457.09 Typical High $1,288.25 | Professional | None | $194.98 | $457.09 | $1,288.25 |
DeanCare Setting Facility Modifier None Typical Low $165.96 Median $234.42 Typical High $436.52 | Facility | None | $165.96 | $234.42 | $436.52 |
DeanCare Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $218.78 | Professional | None | $141.25 | $218.78 | $218.78 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $4,073.80 Typical High $5,011.87 | Facility | None | $199.53 | $4,073.80 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,348.96 Typical High $1,348.96 | Professional | None | $323.59 | $1,348.96 | $1,348.96 |
Prevea360 Setting Facility Modifier None Typical Low $165.96 Median $234.42 Typical High $436.52 | Facility | None | $165.96 | $234.42 | $436.52 |
Prevea360 Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Quartz Setting Professional Modifier None Typical Low $245.47 Median $501.19 Typical High $691.83 | Professional | None | $245.47 | $501.19 | $691.83 |
Security Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $426.58 | Professional | None | $331.13 | $380.19 | $426.58 |
5 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 52 · Reduced service Typical Low $85.11 Median $85.11 Typical High $416.87 | Professional | 52 · Reduced service | $85.11 | $85.11 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $169.82 | Professional | 53 · Discontinued | $33.88 | $33.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $630.96 | Professional | 54 · Surgery only | $125.89 | $125.89 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $125.89 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $83.18 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $83.18 |
Where Wisconsin sits
The same service costs 25.7 times more in Oklahoma than in Vermont. 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· 10th of 51
$447
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.