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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $346.74 Typical High $954.99 | Professional | None | $190.55 | $346.74 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $1,230.27 | Professional | None | $181.97 | $309.03 | $1,230.27 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $169.82 Typical High $251.19 | Professional | None | $165.96 | $169.82 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $831.76 Typical High $1,258.93 | Facility | None | $741.31 | $831.76 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $457.09 | Professional | None | $165.96 | $165.96 | $457.09 |
DeanCare Setting Facility Modifier None Typical Low $239.88 Median $309.03 Typical High $588.84 | Facility | None | $239.88 | $309.03 | $588.84 |
DeanCare Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $562.34 Typical High $891.25 | Facility | None | $263.03 | $562.34 | $891.25 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $562.34 Typical High $1,174.90 | Professional | None | $275.42 | $562.34 | $1,174.90 |
Prevea360 Setting Facility Modifier None Typical Low $239.88 Median $309.03 Typical High $588.84 | Facility | None | $239.88 | $309.03 | $588.84 |
Quartz Setting Professional Modifier None Typical Low $213.80 Median $407.38 Typical High $588.84 | Professional | None | $213.80 | $407.38 | $588.84 |
Quartz Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Security Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Security Health Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $1,023.29 | Professional | None | $389.05 | $489.78 | $1,023.29 |
The Alliance Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $489.78 | Professional | None | $251.19 | $398.11 | $489.78 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
United Setting Professional Modifier None Typical Low $186.21 Median $389.05 Typical High $891.25 | Professional | None | $186.21 | $389.05 | $891.25 |
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 $100.00 Median $173.78 Typical High $478.63 | Professional | 52 · Reduced service | $100.00 | $173.78 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $69.18 Typical High $194.98 | Professional | 53 · Discontinued | $39.81 | $69.18 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $51.29 Typical High $144.54 | Professional | 55 · Aftercare only | $30.20 | $51.29 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $34.67 Typical High $95.50 | Professional | 56 · Pre-op care only | $19.95 | $34.67 | $95.50 |
Where Wisconsin sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 4th of 51
$347
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.