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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $181.97 | Professional | None | $53.70 | $66.07 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $302.00 Typical High $457.09 | Facility | None | $269.15 | $302.00 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $141.25 | Professional | None | $47.86 | $47.86 | $141.25 |
DeanCare Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $125.89 | Facility | None | $54.95 | $66.07 | $125.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $125.89 | Facility | None | $54.95 | $66.07 | $125.89 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $363.08 | Professional | None | $69.18 | $128.82 | $363.08 |
Network Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Prevea360 Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $125.89 | Facility | None | $54.95 | $66.07 | $125.89 |
Quartz Setting Professional Modifier None Typical Low $61.66 Median $117.49 Typical High $144.54 | Professional | None | $61.66 | $117.49 | $144.54 |
Quartz Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $223.87 | Professional | None | $60.26 | $91.20 | $223.87 |
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 $24.55 Median $24.55 Typical High $33.11 | Professional | 52 · Reduced service | $24.55 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $13.18 | Professional | 53 · Discontinued | $9.77 | $9.77 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $10.00 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $6.61 |
Where Wisconsin sits
The same service costs 3.0 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
$72.44
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.