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 $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $16.60 | Professional | None | $12.30 | $12.30 | $16.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $16.60 Typical High $45.71 | Professional | None | $13.49 | $16.60 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $229.09 Typical High $338.84 | Facility | None | $204.17 | $229.09 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $104.71 | Professional | None | $12.02 | $12.02 | $104.71 |
DeanCare Setting Facility Modifier None Typical Low $13.80 Median $16.60 Typical High $93.33 | Facility | None | $13.80 | $16.60 | $93.33 |
Medica Setting Facility Modifier None Typical Low $13.80 Median $16.60 Typical High $93.33 | Facility | None | $13.80 | $16.60 | $93.33 |
Medica Setting Professional Modifier None Typical Low $17.38 Median $31.62 Typical High $91.20 | Professional | None | $17.38 | $31.62 | $91.20 |
Network Health Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Prevea360 Setting Facility Modifier None Typical Low $13.80 Median $16.60 Typical High $93.33 | Facility | None | $13.80 | $16.60 | $93.33 |
Quartz Setting Professional Modifier None Typical Low $15.49 Median $29.51 Typical High $36.31 | Professional | None | $15.49 | $29.51 | $36.31 |
Quartz Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
United Setting Professional Modifier None Typical Low $14.13 Median $22.39 Typical High $53.70 | Professional | None | $14.13 | $22.39 | $53.70 |
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 $6.17 Median $6.17 Typical High $8.32 | Professional | 52 · Reduced service | $6.17 | $6.17 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $3.31 | Professional | 53 · Discontinued | $2.45 | $2.45 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $2.51 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.66 |
Where Wisconsin sits
The same service costs 4.9 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· 19th of 51
$18.20
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.