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 $1.32 Median $1.32 Typical High $2.95 | Facility | None | $1.32 | $1.32 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Facility | None | $1.62 | $1.62 | $1.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.29 Median $1.45 Typical High $1.66 | Professional | None | $1.29 | $1.45 | $1.66 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $2.14 Typical High $3.98 | Facility | None | $1.74 | $2.14 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.41 Typical High $1.62 | Professional | None | $1.29 | $1.41 | $1.62 |
DeanCare Setting Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $2.88 | Facility | None | $1.23 | $1.23 | $2.88 |
DeanCare Setting Professional Modifier None Typical Low $1.82 Median $2.45 Typical High $3.98 | Professional | None | $1.82 | $2.45 | $3.98 |
Medica Setting Facility Modifier None Typical Low $1.23 Median $8.71 Typical High $12.30 | Facility | None | $1.23 | $8.71 | $12.30 |
Medica Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $2.45 | Professional | None | $1.23 | $1.23 | $2.45 |
Network Health Setting Facility Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Facility | None | $1.35 | $1.35 | $1.35 |
Prevea360 Setting Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $2.88 | Facility | None | $1.23 | $1.23 | $2.88 |
Prevea360 Setting Professional Modifier None Typical Low $1.82 Median $2.45 Typical High $3.98 | Professional | None | $1.82 | $2.45 | $3.98 |
Quartz Setting Professional Modifier None Typical Low $1.29 Median $2.04 Typical High $4.79 | Professional | None | $1.29 | $2.04 | $4.79 |
Quartz Setting Facility Modifier None Typical Low $1.74 Median $3.98 Typical High $3.98 | Facility | None | $1.74 | $3.98 | $3.98 |
Quartz Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Security Health Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $2.69 | Professional | None | $1.78 | $1.78 | $2.69 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.74 | Professional | None | $1.26 | $1.26 | $1.74 |
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 $0.68 Median $0.68 Typical High $0.68 | Professional | 52 · Reduced service | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $8.13 | Professional | 53 · Discontinued | $0.27 | $0.27 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $10.47 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $7.08 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $7.08 |
Where Wisconsin sits
The same service costs 2.5 times more in Texas than in Nebraska. 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· 13th of 51
$1.45
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.