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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $229.09 | Professional | None | $165.96 | $229.09 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $616.60 Typical High $912.01 | Professional | None | $302.00 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $794.33 Typical High $1,202.26 | Facility | None | $707.95 | $794.33 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $676.08 | Professional | None | $204.17 | $380.19 | $676.08 |
DeanCare Setting Facility Modifier None Typical Low $199.53 Median $288.40 Typical High $537.03 | Facility | None | $199.53 | $288.40 | $537.03 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $288.40 Typical High $537.03 | Facility | None | $199.53 | $288.40 | $537.03 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $630.96 Typical High $812.83 | Professional | None | $281.84 | $630.96 | $812.83 |
Prevea360 Setting Facility Modifier None Typical Low $199.53 Median $288.40 Typical High $537.03 | Facility | None | $199.53 | $288.40 | $537.03 |
Quartz Setting Professional Modifier None Typical Low $263.03 Median $524.81 Typical High $758.58 | Professional | None | $263.03 | $524.81 | $758.58 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $234.42 Median $630.96 Typical High $933.25 | Professional | None | $234.42 | $630.96 | $933.25 |
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 $83.18 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $83.18 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $33.11 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $25.12 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.60 | $22.91 | $22.91 |
Where Wisconsin sits
The same service costs 26.9 times more in Alaska than in Virginia. 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· 2nd of 51
$525
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.