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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | None | $36.31 | $36.31 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $173.78 | Professional | None | $40.74 | $40.74 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $128.82 Typical High $190.55 | Facility | None | $114.82 | $128.82 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $58.88 | Professional | None | $37.15 | $37.15 | $58.88 |
DeanCare Setting Facility Modifier None Typical Low $38.02 Median $45.71 Typical High $87.10 | Facility | None | $38.02 | $45.71 | $87.10 |
DeanCare Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $117.49 | Professional | None | $50.12 | $87.10 | $117.49 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $47.86 Typical High $100.00 | Facility | None | $38.02 | $47.86 | $100.00 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $269.15 | Professional | None | $28.84 | $44.67 | $269.15 |
Network Health Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Network Health Setting Professional Modifier None Typical Low $28.84 Median $72.44 Typical High $85.11 | Professional | None | $28.84 | $72.44 | $85.11 |
Prevea360 Setting Facility Modifier None Typical Low $38.02 Median $45.71 Typical High $87.10 | Facility | None | $38.02 | $45.71 | $87.10 |
Quartz Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $95.50 | Professional | None | $43.65 | $44.67 | $95.50 |
Quartz Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Security Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Security Health Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $91.20 | Professional | None | $56.23 | $66.07 | $91.20 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $28.84 Median $41.69 Typical High $72.44 | Professional | None | $28.84 | $41.69 | $72.44 |
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 $18.20 Median $18.20 Typical High $20.89 | Professional | 52 · Reduced service | $18.20 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $8.32 | Professional | 53 · Discontinued | $7.24 | $7.24 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.31 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $4.17 |
Where Wisconsin sits
The same service costs 12.9 times more in Hawaii 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· 24th of 51
$40.74
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.