How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $0.41 Median $0.41 Typical High $1.10 | Facility | None | $0.41 | $0.41 | $1.10 |
Aetna Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $7.08 | Professional | None | $0.41 | $0.41 | $7.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Facility | None | $0.49 | $0.49 | $0.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.39 Median $0.42 Typical High $0.49 | Professional | None | $0.39 | $0.42 | $0.49 |
Cigna Setting Facility Modifier None Typical Low $0.62 Median $1.20 Typical High $1.45 | Facility | None | $0.62 | $1.20 | $1.45 |
Cigna Setting Professional Modifier None Typical Low $0.39 Median $0.62 Typical High $0.98 | Professional | None | $0.39 | $0.62 | $0.98 |
DeanCare Setting Facility Modifier None Typical Low $0.56 Median $0.56 Typical High $1.41 | Facility | None | $0.56 | $0.56 | $1.41 |
DeanCare Setting Professional Modifier None Typical Low $0.83 Median $1.12 Typical High $1.12 | Professional | None | $0.83 | $1.12 | $1.12 |
Medica Setting Facility Modifier None Typical Low $0.46 Median $2.82 Typical High $6.31 | Facility | None | $0.46 | $2.82 | $6.31 |
Medica Setting Professional Modifier None Typical Low $0.46 Median $0.46 Typical High $1.12 | Professional | None | $0.46 | $0.46 | $1.12 |
Network Health Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Facility | None | $0.65 | $0.65 | $0.65 |
Prevea360 Setting Facility Modifier None Typical Low $0.56 Median $0.56 Typical High $1.41 | Facility | None | $0.56 | $0.56 | $1.41 |
Prevea360 Setting Professional Modifier None Typical Low $0.83 Median $1.12 Typical High $1.12 | Professional | None | $0.83 | $1.12 | $1.12 |
Quartz Setting Professional Modifier None Typical Low $0.39 Median $0.89 Typical High $1.74 | Professional | None | $0.39 | $0.89 | $1.74 |
Quartz Setting Facility Modifier None Typical Low $0.52 Median $1.20 Typical High $1.20 | Facility | None | $0.52 | $1.20 | $1.20 |
Quartz Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
Security Health Setting Professional Modifier None Typical Low $0.52 Median $0.54 Typical High $0.81 | Professional | None | $0.52 | $0.54 | $0.81 |
United Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.66 | Professional | None | $0.48 | $0.48 | $0.66 |
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 $0.21 Median $0.21 Typical High $3.47 | Professional | 52 · Reduced service | $0.21 | $0.21 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $1.41 | Professional | 53 · Discontinued | $0.08 | $0.08 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $1.05 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.71 |
Where Wisconsin sits
The same service costs 5.2 times more in Wyoming than in Georgia. 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· 13th of 51
$0.48
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.