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 $0.74 Median $0.74 Typical High $1.66 | Facility | None | $0.74 | $0.74 | $1.66 |
Aetna Setting Professional Modifier None Typical Low $0.74 Median $0.74 Typical High $10.00 | Professional | None | $0.74 | $0.74 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.33 Median $0.76 Typical High $1.82 | Professional | None | $0.33 | $0.76 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.82 Typical High $2.45 | Facility | None | $1.10 | $1.82 | $2.45 |
Cigna Setting Professional Modifier None Typical Low $0.56 Median $0.79 Typical High $0.93 | Professional | None | $0.56 | $0.79 | $0.93 |
DeanCare Setting Facility Modifier None Typical Low $0.33 Median $0.37 Typical High $0.74 | Facility | None | $0.33 | $0.37 | $0.74 |
DeanCare Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Medica Setting Facility Modifier None Typical Low $0.33 Median $0.37 Typical High $0.74 | Facility | None | $0.33 | $0.37 | $0.74 |
Medica Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.10 | Professional | None | $0.79 | $0.79 | $1.10 |
Prevea360 Setting Facility Modifier None Typical Low $0.33 Median $0.37 Typical High $0.74 | Facility | None | $0.33 | $0.37 | $0.74 |
Prevea360 Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Quartz Setting Professional Modifier None Typical Low $0.37 Median $0.76 Typical High $1.05 | Professional | None | $0.37 | $0.76 | $1.05 |
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 $0.03 Median $0.04 Typical High $0.04 | Professional | None | $0.03 | $0.04 | $0.04 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.10 | Professional | None | $0.79 | $0.79 | $1.10 |
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 $0.37 Median $0.37 Typical High $5.01 | Professional | 52 · Reduced service | $0.37 | $0.37 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $2.00 | Professional | 53 · Discontinued | $0.15 | $0.15 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $1.51 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $1.00 |
Where Wisconsin sits
The same service costs 14.5 times more in Kansas than in Montana. 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· 45th of 51
$0.79
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.