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 $0.63 Median $0.63 Typical High $1.48 | Facility | None | $0.63 | $0.63 | $1.48 |
Aetna Setting Professional Modifier None Typical Low $0.63 Median $0.63 Typical High $0.63 | Professional | None | $0.63 | $0.63 | $0.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Facility | None | $0.76 | $0.76 | $0.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.62 Median $0.68 Typical High $0.76 | Professional | None | $0.62 | $0.68 | $0.76 |
Cigna Setting Facility Modifier None Typical Low $0.87 Median $1.45 Typical High $1.86 | Facility | None | $0.87 | $1.45 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $0.62 Median $0.79 Typical High $1.10 | Professional | None | $0.62 | $0.79 | $1.10 |
DeanCare Setting Facility Modifier None Typical Low $0.55 Median $0.55 Typical High $1.41 | Facility | None | $0.55 | $0.55 | $1.41 |
DeanCare Setting Professional Modifier None Typical Low $0.83 Median $1.10 Typical High $1.58 | Professional | None | $0.83 | $1.10 | $1.58 |
Medica Setting Facility Modifier None Typical Low $0.49 Median $0.49 Typical High $3.47 | Facility | None | $0.49 | $0.49 | $3.47 |
Medica Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $1.10 | Professional | None | $0.49 | $0.49 | $1.10 |
Network Health Setting Facility Modifier None Typical Low $1.07 Median $1.07 Typical High $1.07 | Facility | None | $1.07 | $1.07 | $1.07 |
Prevea360 Setting Facility Modifier None Typical Low $0.55 Median $0.55 Typical High $1.41 | Facility | None | $0.55 | $0.55 | $1.41 |
Prevea360 Setting Professional Modifier None Typical Low $0.83 Median $1.10 Typical High $1.58 | Professional | None | $0.83 | $1.10 | $1.58 |
Quartz Setting Professional Modifier None Typical Low $0.62 Median $1.02 Typical High $2.40 | Professional | None | $0.62 | $1.02 | $2.40 |
Quartz Setting Facility Modifier None Typical Low $0.81 Median $1.86 Typical High $1.86 | Facility | None | $0.81 | $1.86 | $1.86 |
Quartz Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
Security Health Setting Professional Modifier None Typical Low $0.81 Median $0.83 Typical High $1.32 | Professional | None | $0.81 | $0.83 | $1.32 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.87 | Professional | None | $0.65 | $0.65 | $0.87 |
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 $0.32 Median $0.32 Typical High $10.00 | Professional | 52 · Reduced service | $0.32 | $0.32 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $3.98 | Professional | 53 · Discontinued | $0.13 | $0.13 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $3.02 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $2.00 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $2.00 |
Where Wisconsin sits
The same service costs 4.7 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· 19th of 51
$0.68
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.