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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | None | $141.25 | $141.25 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $501.19 | Professional | None | $154.88 | $177.83 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $478.63 Typical High $707.95 | Facility | None | $416.87 | $478.63 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $416.87 | Professional | None | $151.36 | $218.78 | $416.87 |
DeanCare Setting Facility Modifier None Typical Low $147.91 Median $181.97 Typical High $323.59 | Facility | None | $147.91 | $181.97 | $323.59 |
DeanCare Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $446.68 | Professional | None | $208.93 | $288.40 | $446.68 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $181.97 Typical High $323.59 | Facility | None | $147.91 | $181.97 | $323.59 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $1,096.48 Typical High $1,096.48 | Professional | None | $239.88 | $1,096.48 | $1,096.48 |
Network Health Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $177.83 | Professional | None | $117.49 | $117.49 | $177.83 |
Prevea360 Setting Facility Modifier None Typical Low $147.91 Median $181.97 Typical High $323.59 | Facility | None | $147.91 | $181.97 | $323.59 |
Quartz Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $380.19 | Professional | None | $181.97 | $218.78 | $380.19 |
Quartz Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $426.58 | Professional | None | $151.36 | $151.36 | $426.58 |
Security Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Security Health Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $346.74 | Professional | None | $257.04 | $302.00 | $346.74 |
United Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $501.19 | Professional | None | $194.98 | $316.23 | $501.19 |
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 $70.79 Median $70.79 Typical High $81.28 | Professional | 52 · Reduced service | $70.79 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $32.36 | Professional | 53 · Discontinued | $28.18 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $16.22 |
Where Wisconsin sits
The same service costs 2.3 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
$191
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.