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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $120.23 | Professional | None | $107.15 | $107.15 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $354.81 | Professional | None | $117.49 | $125.89 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $363.08 Typical High $537.03 | Facility | None | $323.59 | $363.08 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $316.23 | Professional | None | $112.20 | $154.88 | $316.23 |
DeanCare Setting Facility Modifier None Typical Low $112.20 Median $134.90 Typical High $245.47 | Facility | None | $112.20 | $134.90 | $245.47 |
DeanCare Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $338.84 | Professional | None | $147.91 | $218.78 | $338.84 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $134.90 Typical High $245.47 | Facility | None | $112.20 | $134.90 | $245.47 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $776.25 Typical High $776.25 | Professional | None | $169.82 | $776.25 | $776.25 |
Network Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $134.90 | Professional | None | $91.20 | $91.20 | $134.90 |
Prevea360 Setting Facility Modifier None Typical Low $112.20 Median $134.90 Typical High $245.47 | Facility | None | $112.20 | $134.90 | $245.47 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $281.84 | Professional | None | $131.83 | $158.49 | $281.84 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $181.97 | Professional | None | $112.20 | $112.20 | $181.97 |
Security Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Security Health Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $251.19 | Professional | None | $181.97 | $218.78 | $251.19 |
United Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $354.81 | Professional | None | $138.04 | $229.09 | $354.81 |
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 $53.70 Median $53.70 Typical High $60.26 | Professional | 52 · Reduced service | $53.70 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $23.99 | Professional | 53 · Discontinued | $21.38 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $18.20 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $12.02 |
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· 13th of 51
$145
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.