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 $0.81 Median $0.81 Typical High $1.95 | Facility | None | $0.81 | $0.81 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $0.81 Median $0.81 Typical High $6.03 | Professional | None | $0.81 | $0.81 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Facility | None | $1.00 | $1.00 | $1.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.79 Median $0.87 Typical High $1.00 | Professional | None | $0.79 | $0.87 | $1.00 |
Cigna Setting Facility Modifier None Typical Low $1.20 Median $2.00 Typical High $2.45 | Facility | None | $1.20 | $2.00 | $2.45 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $1.02 Typical High $1.51 | Professional | None | $0.79 | $1.02 | $1.51 |
DeanCare Setting Facility Modifier None Typical Low $0.66 Median $0.79 Typical High $1.41 | Facility | None | $0.66 | $0.79 | $1.41 |
DeanCare Setting Professional Modifier None Typical Low $1.07 Median $1.58 Typical High $1.58 | Professional | None | $1.07 | $1.58 | $1.58 |
Medica Setting Facility Modifier None Typical Low $0.83 Median $5.37 Typical High $9.33 | Facility | None | $0.83 | $5.37 | $9.33 |
Medica Setting Professional Modifier None Typical Low $0.83 Median $0.83 Typical High $1.58 | Professional | None | $0.83 | $0.83 | $1.58 |
Network Health Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $1.55 | Facility | None | $0.81 | $0.81 | $1.55 |
Prevea360 Setting Facility Modifier None Typical Low $0.66 Median $0.79 Typical High $1.41 | Facility | None | $0.66 | $0.79 | $1.41 |
Prevea360 Setting Professional Modifier None Typical Low $1.07 Median $1.58 Typical High $1.58 | Professional | None | $1.07 | $1.58 | $1.58 |
Quartz Setting Professional Modifier None Typical Low $0.79 Median $1.35 Typical High $1.74 | Professional | None | $0.79 | $1.35 | $1.74 |
Quartz Setting Facility Modifier None Typical Low $1.07 Median $2.45 Typical High $2.45 | Facility | None | $1.07 | $2.45 | $2.45 |
Quartz Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Security Health Setting Professional Modifier None Typical Low $0.87 Median $1.07 Typical High $1.32 | Professional | None | $0.87 | $1.07 | $1.32 |
United Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $1.15 | Professional | None | $0.85 | $0.85 | $1.15 |
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 $0.41 Median $0.41 Typical High $7.59 | Professional | 52 · Reduced service | $0.41 | $0.41 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $3.02 | Professional | 53 · Discontinued | $0.16 | $0.16 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $2.24 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $1.51 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $1.51 |
Where Wisconsin sits
The same service costs 2.3 times more in Alaska 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· 14th of 51
$0.95
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.