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 $0.33 Median $0.33 Typical High $0.78 | Facility | None | $0.33 | $0.33 | $0.78 |
Aetna Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $2.00 | Professional | None | $0.33 | $0.33 | $2.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.33 Median $0.76 Typical High $1.82 | Professional | None | $0.33 | $0.76 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.82 Typical High $2.29 | Facility | None | $1.10 | $1.82 | $2.29 |
Cigna Setting Professional Modifier None Typical Low $0.56 Median $0.76 Typical High $0.93 | Professional | None | $0.56 | $0.76 | $0.93 |
DeanCare Setting Facility Modifier None Typical Low $0.31 Median $0.76 Typical High $0.76 | Facility | None | $0.31 | $0.76 | $0.76 |
DeanCare Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $1.12 | Professional | None | $0.26 | $0.26 | $1.12 |
Medica Setting Facility Modifier None Typical Low $0.31 Median $0.76 Typical High $0.76 | Facility | None | $0.31 | $0.76 | $0.76 |
Medica Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $1.17 | Professional | None | $0.85 | $0.85 | $1.17 |
Network Health Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $5.62 | Facility | None | $0.35 | $0.35 | $5.62 |
Prevea360 Setting Facility Modifier None Typical Low $0.31 Median $0.76 Typical High $0.76 | Facility | None | $0.31 | $0.76 | $0.76 |
Prevea360 Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $1.12 | Professional | None | $0.26 | $0.26 | $1.12 |
Quartz Setting Professional Modifier None Typical Low $0.37 Median $0.76 Typical High $1.05 | Professional | None | $0.37 | $0.76 | $1.05 |
Quartz Setting Facility Modifier None Typical Low $1.00 Median $2.29 Typical High $2.29 | Facility | None | $1.00 | $2.29 | $2.29 |
Quartz Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Security Health Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.91 | Professional | None | $0.48 | $0.48 | $0.91 |
United Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $1.17 | Professional | None | $0.85 | $0.85 | $1.17 |
2 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 $0.17 Median $0.17 Typical High $1.00 | Professional | 52 · Reduced service | $0.17 | $0.17 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.40 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.40 |
Where Wisconsin sits
The same service costs 1.6 times more in Massachusetts than in Colorado. 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· 3rd of 51
$0.85
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.