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 $3.63 Median $3.63 Typical High $8.13 | Facility | None | $3.63 | $3.63 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $16.98 | Professional | None | $3.63 | $3.63 | $16.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $7.59 | Facility | None | $4.37 | $4.37 | $7.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.89 Typical High $4.47 | Professional | None | $3.55 | $3.89 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $5.25 Median $8.51 Typical High $10.72 | Facility | None | $5.25 | $8.51 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $4.47 Typical High $6.46 | Professional | None | $3.55 | $4.47 | $6.46 |
DeanCare Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $7.76 | Facility | None | $3.47 | $3.47 | $7.76 |
DeanCare Setting Professional Modifier None Typical Low $5.25 Median $7.08 Typical High $7.08 | Professional | None | $5.25 | $7.08 | $7.08 |
Medica Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $7.76 | Facility | None | $3.55 | $3.55 | $7.76 |
Medica Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $5.37 | Professional | None | $3.55 | $3.55 | $5.37 |
Network Health Setting Facility Modifier None Typical Low $3.63 Median $3.80 Typical High $3.80 | Facility | None | $3.63 | $3.80 | $3.80 |
Prevea360 Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $7.76 | Facility | None | $3.47 | $3.47 | $7.76 |
Prevea360 Setting Professional Modifier None Typical Low $5.25 Median $7.08 Typical High $7.08 | Professional | None | $5.25 | $7.08 | $7.08 |
Quartz Setting Professional Modifier None Typical Low $3.55 Median $5.62 Typical High $8.51 | Professional | None | $3.55 | $5.62 | $8.51 |
Quartz Setting Facility Modifier None Typical Low $4.68 Median $10.72 Typical High $10.72 | Facility | None | $4.68 | $10.72 | $10.72 |
Quartz Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Security Health Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $5.89 | Professional | None | $4.79 | $4.79 | $5.89 |
United Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.79 | Professional | None | $3.55 | $3.55 | $4.79 |
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 $1.82 Median $1.82 Typical High $8.51 | Professional | 52 · Reduced service | $1.82 | $1.82 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $3.39 | Professional | 53 · Discontinued | $0.72 | $0.72 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.54 Typical High $2.51 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $1.70 |
Where Wisconsin sits
The same service costs 1.7 times more in Arizona than in Illinois. 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· 8th of 51
$4.07
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.