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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $60.26 | Professional | None | $41.69 | $41.69 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $173.78 Typical High $199.53 | Professional | None | $43.65 | $173.78 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $147.91 Typical High $218.78 | Facility | None | $128.82 | $147.91 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $53.70 Typical High $85.11 | Professional | None | $46.77 | $53.70 | $85.11 |
DeanCare Setting Facility Modifier None Typical Low $40.74 Median $47.86 Typical High $74.13 | Facility | None | $40.74 | $47.86 | $74.13 |
Medica Setting Facility Modifier None Typical Low $40.74 Median $52.48 Typical High $251.19 | Facility | None | $40.74 | $52.48 | $251.19 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $134.90 | Professional | None | $44.67 | $70.79 | $134.90 |
Network Health Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $77.62 | Professional | None | $41.69 | $52.48 | $77.62 |
Prevea360 Setting Facility Modifier None Typical Low $40.74 Median $47.86 Typical High $74.13 | Facility | None | $40.74 | $47.86 | $74.13 |
Quartz Setting Professional Modifier None Typical Low $56.23 Median $117.49 Typical High $141.25 | Professional | None | $56.23 | $117.49 | $141.25 |
Quartz Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Security Health Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $309.03 | Professional | None | $48.98 | $61.66 | $309.03 |
United Setting Professional Modifier None Typical Low $48.98 Median $93.33 Typical High $154.88 | Professional | None | $48.98 | $93.33 | $154.88 |
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 $20.89 Median $20.89 Typical High $30.20 | Professional | 52 · Reduced service | $20.89 | $20.89 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $12.02 | Professional | 53 · Discontinued | $8.32 | $8.32 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $8.91 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $6.03 |
Where Wisconsin sits
The same service costs 4.9 times more in Alabama than in Louisiana. 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
$112
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.