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 $8.71 Median $8.71 Typical High $21.38 | Facility | None | $8.71 | $8.71 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.51 Median $9.33 Typical High $10.72 | Professional | None | $8.51 | $9.33 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $25.70 Typical High $31.62 | Facility | None | $13.18 | $25.70 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $15.49 Typical High $20.89 | Professional | None | $8.51 | $15.49 | $20.89 |
DeanCare Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $64.57 | Facility | None | $11.48 | $11.48 | $64.57 |
DeanCare Setting Professional Modifier None Typical Low $9.55 Median $22.91 Typical High $22.91 | Professional | None | $9.55 | $22.91 | $22.91 |
Medica Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $117.49 | Facility | None | $11.75 | $11.75 | $117.49 |
Medica Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $22.91 | Professional | None | $11.75 | $11.75 | $22.91 |
Network Health Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $69.18 | Facility | None | $26.30 | $26.30 | $69.18 |
Prevea360 Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $64.57 | Facility | None | $11.48 | $11.48 | $64.57 |
Prevea360 Setting Professional Modifier None Typical Low $9.55 Median $22.91 Typical High $22.91 | Professional | None | $9.55 | $22.91 | $22.91 |
Quartz Setting Professional Modifier None Typical Low $8.51 Median $15.14 Typical High $29.51 | Professional | None | $8.51 | $15.14 | $29.51 |
Quartz Setting Facility Modifier None Typical Low $11.22 Median $25.70 Typical High $25.70 | Facility | None | $11.22 | $25.70 | $25.70 |
Quartz Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Security Health Setting Professional Modifier None Typical Low $11.48 Median $11.75 Typical High $74.13 | Professional | None | $11.48 | $11.75 | $74.13 |
United Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $12.88 | Professional | None | $9.33 | $9.33 | $12.88 |
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 $4.37 Median $4.37 Typical High $83.18 | Professional | 52 · Reduced service | $4.37 | $4.37 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $1.78 Typical High $33.88 | Professional | 53 · Discontinued | $1.78 | $1.78 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.32 Median $1.32 Typical High $25.12 | Professional | 55 · Aftercare only | $1.32 | $1.32 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $16.98 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $16.98 |
Where Wisconsin sits
The same service costs 6.5 times more in Oklahoma than in Alabama. 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· 18th of 51
$10.72
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.