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 $0.66 Median $0.66 Typical High $1.48 | Facility | None | $0.66 | $0.66 | $1.48 |
Aetna Setting Professional Modifier None Typical Low $0.66 Median $0.66 Typical High $3.98 | Professional | None | $0.66 | $0.66 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $1.70 | Professional | None | $0.68 | $0.68 | $1.70 |
Cigna Setting Facility Modifier None Typical Low $1.05 Median $1.70 Typical High $2.14 | Facility | None | $1.05 | $1.70 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $0.71 Median $0.89 Typical High $1.26 | Professional | None | $0.71 | $0.89 | $1.26 |
DeanCare Setting Facility Modifier None Typical Low $0.66 Median $0.72 Typical High $0.72 | Facility | None | $0.66 | $0.72 | $0.72 |
DeanCare Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | None | $1.07 | $1.07 | $1.07 |
Medica Setting Facility Modifier None Typical Low $0.66 Median $0.72 Typical High $0.72 | Facility | None | $0.66 | $0.72 | $0.72 |
Medica Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.93 | Professional | None | $0.68 | $0.68 | $0.93 |
Network Health Setting Facility Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Facility | None | $0.76 | $0.76 | $0.76 |
Prevea360 Setting Facility Modifier None Typical Low $0.66 Median $0.72 Typical High $0.72 | Facility | None | $0.66 | $0.72 | $0.72 |
Prevea360 Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | None | $1.07 | $1.07 | $1.07 |
Quartz Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Quartz Setting Facility Modifier None Typical Low $0.93 Median $2.14 Typical High $2.14 | Facility | None | $0.93 | $2.14 | $2.14 |
Quartz Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
Security Health Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $1.20 | Professional | None | $0.98 | $0.98 | $1.20 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.93 | Professional | None | $0.68 | $0.68 | $0.93 |
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 $0.33 Median $0.33 Typical High $2.00 | Professional | 52 · Reduced service | $0.33 | $0.33 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.79 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.60 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.40 |
Where Wisconsin sits
The same service costs 1.7 times more in Arizona than in North Dakota. 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· 16th of 51
$0.72
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.