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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $27.54 | Professional | None | $20.42 | $20.42 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $27.54 Typical High $75.86 | Professional | None | $22.39 | $27.54 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $114.82 Typical High $169.82 | Facility | None | $100.00 | $114.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $52.48 | Professional | None | $19.50 | $19.50 | $52.48 |
DeanCare Setting Facility Modifier None Typical Low $22.91 Median $27.54 Typical High $48.98 | Facility | None | $22.91 | $27.54 | $48.98 |
Medica Setting Facility Modifier None Typical Low $22.91 Median $27.54 Typical High $48.98 | Facility | None | $22.91 | $27.54 | $48.98 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $53.70 Typical High $151.36 | Professional | None | $28.84 | $53.70 | $151.36 |
Network Health Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Prevea360 Setting Facility Modifier None Typical Low $22.91 Median $27.54 Typical High $48.98 | Facility | None | $22.91 | $27.54 | $48.98 |
Quartz Setting Professional Modifier None Typical Low $25.70 Median $47.86 Typical High $60.26 | Professional | None | $25.70 | $47.86 | $60.26 |
Quartz Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $93.33 | Professional | None | $24.55 | $38.02 | $93.33 |
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 $10.23 Median $10.23 Typical High $13.80 | Professional | 52 · Reduced service | $10.23 | $10.23 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $5.50 | Professional | 53 · Discontinued | $4.07 | $4.07 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $4.07 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.75 |
Where Wisconsin sits
The same service costs 2.7 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· 18th of 51
$30.20
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.