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 $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $66.07 | Professional | None | $10.00 | $10.00 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $52.48 Typical High $104.71 | Professional | None | $20.89 | $52.48 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $104.71 Typical High $154.88 | Facility | None | $91.20 | $104.71 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $32.36 Typical High $87.10 | Professional | None | $20.89 | $32.36 | $87.10 |
DeanCare Setting Facility Modifier None Typical Low $6.92 Median $22.91 Typical High $43.65 | Facility | None | $6.92 | $22.91 | $43.65 |
DeanCare Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Medica Setting Facility Modifier None Typical Low $16.22 Median $43.65 Typical High $117.49 | Facility | None | $16.22 | $43.65 | $117.49 |
Medica Setting Professional Modifier None Typical Low $13.80 Median $33.11 Typical High $64.57 | Professional | None | $13.80 | $33.11 | $64.57 |
Prevea360 Setting Facility Modifier None Typical Low $6.92 Median $22.91 Typical High $43.65 | Facility | None | $6.92 | $22.91 | $43.65 |
Prevea360 Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Quartz Setting Professional Modifier None Typical Low $35.48 Median $72.44 Typical High $104.71 | Professional | None | $35.48 | $72.44 | $104.71 |
Quartz Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Security Health Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Security Health Setting Facility Modifier None Typical Low $18.20 Median $21.88 Typical High $25.12 | Facility | None | $18.20 | $21.88 | $25.12 |
Security Health Setting Professional Modifier None Typical Low $19.95 Median $23.99 Typical High $79.43 | Professional | None | $19.95 | $23.99 | $79.43 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $13.80 Median $34.67 Typical High $67.61 | Professional | None | $13.80 | $34.67 | $67.61 |
4 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 $5.01 Median $5.01 Typical High $33.11 | Professional | 52 · Reduced service | $5.01 | $5.01 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $13.18 | Professional | 53 · Discontinued | $2.00 | $2.00 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $10.00 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $6.61 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $6.61 |
Where Wisconsin sits
The same service costs 6.6 times more in Alabama than in Kansas. 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
$42.66
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.