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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $54.95 | Professional | None | $40.74 | $40.74 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $151.36 | Professional | None | $44.67 | $54.95 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $346.74 Typical High $512.86 | Facility | None | $302.00 | $346.74 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $158.49 | Professional | None | $39.81 | $39.81 | $158.49 |
DeanCare Setting Facility Modifier None Typical Low $45.71 Median $54.95 Typical High $141.25 | Facility | None | $45.71 | $54.95 | $141.25 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $54.95 Typical High $141.25 | Facility | None | $45.71 | $54.95 | $141.25 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $107.15 Typical High $302.00 | Professional | None | $57.54 | $107.15 | $302.00 |
Network Health Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Prevea360 Setting Facility Modifier None Typical Low $45.71 Median $54.95 Typical High $141.25 | Facility | None | $45.71 | $54.95 | $141.25 |
Quartz Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $120.23 | Professional | None | $51.29 | $97.72 | $120.23 |
Quartz Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $186.21 | Professional | None | $48.98 | $75.86 | $186.21 |
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 $20.42 Median $20.42 Typical High $27.54 | Professional | 52 · Reduced service | $20.42 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $10.96 | Professional | 53 · Discontinued | $8.13 | $8.13 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $8.32 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $5.50 |
Where Wisconsin sits
The same service costs 4.0 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
$60.26
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.