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 $44.67 Median $44.67 Typical High $125.89 | Facility | None | $44.67 | $44.67 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $338.84 | Professional | None | $44.67 | $44.67 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $56.23 | Professional | None | $43.65 | $47.86 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $134.90 Typical High $165.96 | Facility | None | $67.61 | $134.90 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $74.13 Typical High $109.65 | Professional | None | $43.65 | $74.13 | $109.65 |
DeanCare Setting Facility Modifier None Typical Low $40.74 Median $50.12 Typical High $109.65 | Facility | None | $40.74 | $50.12 | $109.65 |
DeanCare Setting Professional Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Professional | None | $50.12 | $100.00 | $100.00 |
Medica Setting Facility Modifier None Typical Low $40.74 Median $67.61 Typical High $147.91 | Facility | None | $40.74 | $67.61 | $147.91 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $100.00 | Professional | None | $67.61 | $67.61 | $100.00 |
Network Health Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Prevea360 Setting Facility Modifier None Typical Low $40.74 Median $50.12 Typical High $109.65 | Facility | None | $40.74 | $50.12 | $109.65 |
Prevea360 Setting Professional Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Professional | None | $50.12 | $100.00 | $100.00 |
Quartz Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $131.83 | Professional | None | $43.65 | $79.43 | $131.83 |
Quartz Setting Facility Modifier None Typical Low $58.88 Median $134.90 Typical High $134.90 | Facility | None | $58.88 | $134.90 | $134.90 |
Quartz Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Security Health Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $85.11 | Professional | None | $46.77 | $58.88 | $85.11 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $74.13 | Professional | None | $54.95 | $54.95 | $74.13 |
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 $22.39 Median $22.39 Typical High $169.82 | Professional | 52 · Reduced service | $22.39 | $22.39 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $67.61 | Professional | 53 · Discontinued | $9.12 | $9.12 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $50.12 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $33.88 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $33.88 |
Where Wisconsin sits
The same service costs 2.0 times more in Alaska than in Wyoming. 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· 28th of 51
$54.95
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.