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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $75.86 | Professional | None | $64.57 | $64.57 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $213.80 | Professional | None | $70.79 | $75.86 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $223.87 Typical High $331.13 | Facility | None | $194.98 | $223.87 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $194.98 | Professional | None | $67.61 | $95.50 | $194.98 |
DeanCare Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $151.36 | Facility | None | $69.18 | $81.28 | $151.36 |
DeanCare Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $204.17 | Professional | None | $89.13 | $134.90 | $204.17 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $151.36 | Facility | None | $69.18 | $81.28 | $151.36 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $467.74 Typical High $467.74 | Professional | None | $102.33 | $467.74 | $467.74 |
Network Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $81.28 | Professional | None | $54.95 | $54.95 | $81.28 |
Prevea360 Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $151.36 | Facility | None | $69.18 | $81.28 | $151.36 |
Quartz Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $169.82 | Professional | None | $81.28 | $97.72 | $169.82 |
Quartz Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $109.65 | Professional | None | $67.61 | $67.61 | $109.65 |
Security Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Security Health Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $151.36 | Professional | None | $109.65 | $128.82 | $151.36 |
United Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $208.93 | Professional | None | $81.28 | $134.90 | $208.93 |
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 $32.36 Median $32.36 Typical High $38.02 | Professional | 52 · Reduced service | $32.36 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | 53 · Discontinued | $12.88 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $11.48 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $7.59 |
Where Wisconsin sits
The same service costs 2.2 times more in Alaska than in Kentucky. 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
$89.13
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.