How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $257.04 Median $257.04 Typical High $14,454.40 | Facility | None | $257.04 | $257.04 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $1,202.26 | Professional | None | $257.04 | $257.04 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,174.90 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $2,691.53 | Facility | None | $812.83 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $15.14 | Professional | None | $5.50 | $5.50 | $15.14 |
DeanCare Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
DeanCare Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $562.34 | Professional | None | $478.63 | $524.81 | $562.34 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $1,000.00 Typical High $1,778.28 | Facility | None | $204.17 | $1,000.00 | $1,778.28 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $2,344.23 | Facility | None | $831.76 | $954.99 | $2,344.23 |
Prevea360 Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $2,691.53 | Facility | None | $812.83 | $1,479.11 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
5 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 $128.82 Median $128.82 Typical High $602.56 | Professional | 52 · Reduced service | $128.82 | $128.82 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $239.88 | Professional | 53 · Discontinued | $51.29 | $51.29 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $912.01 | Professional | 54 · Surgery only | $194.98 | $194.98 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $181.97 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $120.23 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $120.23 |
Where Wisconsin sits
The same service costs 281.8 times more in North Dakota than in Vermont. 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· 6th of 51
$955
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.