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 $10.23 Median $10.23 Typical High $19.50 | Facility | None | $10.23 | $10.23 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $67.61 | Professional | None | $10.23 | $10.23 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $12.59 | Professional | None | $10.00 | $10.96 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $20.89 Typical High $30.90 | Facility | None | $13.18 | $20.89 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $15.49 | Professional | None | $10.00 | $12.88 | $15.49 |
DeanCare Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $19.95 | Facility | None | $8.91 | $8.91 | $19.95 |
DeanCare Setting Professional Modifier None Typical Low $8.51 Median $18.20 Typical High $18.20 | Professional | None | $8.51 | $18.20 | $18.20 |
Medica Setting Facility Modifier None Typical Low $8.91 Median $9.12 Typical High $19.95 | Facility | None | $8.91 | $9.12 | $19.95 |
Medica Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $18.20 | Professional | None | $9.12 | $9.12 | $18.20 |
Network Health Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $16.98 | Facility | None | $9.12 | $9.12 | $16.98 |
Prevea360 Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $19.95 | Facility | None | $8.91 | $8.91 | $19.95 |
Prevea360 Setting Professional Modifier None Typical Low $8.51 Median $18.20 Typical High $18.20 | Professional | None | $8.51 | $18.20 | $18.20 |
Quartz Setting Professional Modifier None Typical Low $10.00 Median $13.80 Typical High $22.91 | Professional | None | $10.00 | $13.80 | $22.91 |
Quartz Setting Facility Modifier None Typical Low $13.18 Median $30.90 Typical High $30.90 | Facility | None | $13.18 | $30.90 | $30.90 |
Quartz Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Security Health Setting Professional Modifier None Typical Low $10.23 Median $13.49 Typical High $16.60 | Professional | None | $10.23 | $13.49 | $16.60 |
United Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $11.75 | Professional | None | $8.51 | $8.51 | $11.75 |
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 $5.13 Median $5.13 Typical High $33.88 | Professional | 52 · Reduced service | $5.13 | $5.13 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.04 Typical High $13.49 | Professional | 53 · Discontinued | $2.04 | $2.04 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $1.55 Typical High $10.00 | Professional | 55 · Aftercare only | $1.55 | $1.55 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.02 Typical High $6.76 | Professional | 56 · Pre-op care only | $1.02 | $1.02 | $6.76 |
Where Wisconsin sits
The same service costs 2.2 times more in Arkansas than in Rhode Island. 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· 11th of 51
$10.96
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.