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 $14.79 Median $14.79 Typical High $33.11 | Facility | None | $14.79 | $14.79 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $134.90 | Professional | None | $14.79 | $14.79 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.45 Median $15.85 Typical High $18.20 | Professional | None | $14.45 | $15.85 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $29.51 Typical High $44.67 | Facility | None | $19.05 | $29.51 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $18.62 Typical High $22.39 | Professional | None | $14.45 | $18.62 | $22.39 |
DeanCare Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $28.18 | Facility | None | $13.18 | $13.18 | $28.18 |
DeanCare Setting Professional Modifier None Typical Low $15.85 Median $26.30 Typical High $26.30 | Professional | None | $15.85 | $26.30 | $26.30 |
Medica Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $25.12 | Facility | None | $11.48 | $11.48 | $25.12 |
Medica Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $26.30 | Professional | None | $11.48 | $11.48 | $26.30 |
Network Health Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Prevea360 Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $28.18 | Facility | None | $13.18 | $13.18 | $28.18 |
Prevea360 Setting Professional Modifier None Typical Low $15.85 Median $26.30 Typical High $26.30 | Professional | None | $15.85 | $26.30 | $26.30 |
Quartz Setting Professional Modifier None Typical Low $14.45 Median $22.91 Typical High $33.88 | Professional | None | $14.45 | $22.91 | $33.88 |
Quartz Setting Facility Modifier None Typical Low $19.05 Median $44.67 Typical High $44.67 | Facility | None | $19.05 | $44.67 | $44.67 |
Quartz Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Security Health Setting Professional Modifier None Typical Low $16.22 Median $19.50 Typical High $23.99 | Professional | None | $16.22 | $19.50 | $23.99 |
United Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $19.50 | Professional | None | $14.13 | $14.13 | $19.50 |
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 $7.41 Median $7.41 Typical High $67.61 | Professional | 52 · Reduced service | $7.41 | $7.41 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $26.92 | Professional | 53 · Discontinued | $3.02 | $3.02 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $20.42 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $13.49 |
Where Wisconsin sits
The same service costs 2.0 times more in Wyoming than in Oklahoma. 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
$15.85
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.