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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $48.98 | Professional | None | $43.65 | $43.65 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $151.36 | Professional | None | $47.86 | $53.70 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $147.91 Typical High $223.87 | Facility | None | $131.83 | $147.91 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $128.82 | Professional | None | $45.71 | $63.10 | $128.82 |
DeanCare Setting Facility Modifier None Typical Low $46.77 Median $56.23 Typical High $102.33 | Facility | None | $46.77 | $56.23 | $102.33 |
DeanCare Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $138.04 | Professional | None | $63.10 | $91.20 | $138.04 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $56.23 Typical High $102.33 | Facility | None | $46.77 | $56.23 | $102.33 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $331.13 Typical High $331.13 | Professional | None | $72.44 | $331.13 | $331.13 |
Network Health Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $56.23 | Professional | None | $37.15 | $37.15 | $56.23 |
Prevea360 Setting Facility Modifier None Typical Low $46.77 Median $56.23 Typical High $102.33 | Facility | None | $46.77 | $56.23 | $102.33 |
Quartz Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $114.82 | Professional | None | $54.95 | $66.07 | $114.82 |
Quartz Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $74.13 | Professional | None | $45.71 | $45.71 | $74.13 |
Security Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Security Health Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $104.71 | Professional | None | $77.62 | $91.20 | $104.71 |
United Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $151.36 | Professional | None | $58.88 | $95.50 | $151.36 |
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 $21.88 Median $21.88 Typical High $24.55 | Professional | 52 · Reduced service | $21.88 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $9.77 | Professional | 53 · Discontinued | $8.91 | $8.91 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $7.24 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.90 |
Where Wisconsin sits
The same service costs 2.2 times more in Alaska than in Arizona. 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· 14th of 51
$58.88
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.