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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $63.10 | Professional | None | $56.23 | $56.23 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $218.78 | Professional | None | $61.66 | $61.66 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $194.98 Typical High $295.12 | Facility | None | $173.78 | $194.98 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $89.13 | Professional | None | $60.26 | $60.26 | $89.13 |
DeanCare Setting Facility Modifier None Typical Low $53.70 Median $70.79 Typical High $131.83 | Facility | None | $53.70 | $70.79 | $131.83 |
DeanCare Setting Professional Modifier None Typical Low $61.66 Median $131.83 Typical High $177.83 | Professional | None | $61.66 | $131.83 | $177.83 |
Medica Setting Facility Modifier None Typical Low $53.70 Median $70.79 Typical High $131.83 | Facility | None | $53.70 | $70.79 | $131.83 |
Medica Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $398.11 | Professional | None | $43.65 | $58.88 | $398.11 |
Network Health Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Network Health Setting Professional Modifier None Typical Low $43.65 Median $104.71 Typical High $128.82 | Professional | None | $43.65 | $104.71 | $128.82 |
Prevea360 Setting Facility Modifier None Typical Low $53.70 Median $70.79 Typical High $131.83 | Facility | None | $53.70 | $70.79 | $131.83 |
Quartz Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $147.91 | Professional | None | $69.18 | $70.79 | $147.91 |
Quartz Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Security Health Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Security Health Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $128.82 | Professional | None | $70.79 | $83.18 | $128.82 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $93.33 | Professional | None | $43.65 | $58.88 | $93.33 |
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 $28.18 Median $28.18 Typical High $31.62 | Professional | 52 · Reduced service | $28.18 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $12.59 | Professional | 53 · Discontinued | $11.22 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $9.55 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.31 |
Where Wisconsin sits
The same service costs 2.6 times more in Alaska than in Utah. 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· 20th of 51
$61.66
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.