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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $229.09 | Professional | None | $93.33 | $93.33 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $323.59 Typical High $977.24 | Professional | None | $102.33 | $323.59 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $316.23 Typical High $478.63 | Facility | None | $281.84 | $316.23 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $269.15 | Professional | None | $102.33 | $117.49 | $269.15 |
DeanCare Setting Facility Modifier None Typical Low $40.74 Median $107.15 Typical High $169.82 | Facility | None | $40.74 | $107.15 | $169.82 |
DeanCare Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $537.03 | Facility | None | $95.50 | $117.49 | $537.03 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $446.68 | Professional | None | $100.00 | $173.78 | $446.68 |
Network Health Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Network Health Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $239.88 | Professional | None | $93.33 | $162.18 | $239.88 |
Prevea360 Setting Facility Modifier None Typical Low $40.74 Median $107.15 Typical High $169.82 | Facility | None | $40.74 | $107.15 | $169.82 |
Prevea360 Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Quartz Setting Professional Modifier None Typical Low $104.71 Median $245.47 Typical High $346.74 | Professional | None | $104.71 | $245.47 | $346.74 |
Quartz Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Security Health Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $218.78 | Professional | None | $138.04 | $154.88 | $218.78 |
United Setting Professional Modifier None Typical Low $104.71 Median $275.42 Typical High $446.68 | Professional | None | $104.71 | $275.42 | $446.68 |
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 $46.77 Median $46.77 Typical High $138.04 | Professional | 52 · Reduced service | $46.77 | $46.77 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $54.95 | Professional | 53 · Discontinued | $18.62 | $18.62 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $40.74 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $27.54 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $27.54 |
Where Wisconsin sits
The same service costs 3.0 times more in Alaska than in West Virginia. 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· 2nd of 51
$240
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.