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 $54.95 Median $54.95 Typical High $120.23 | Facility | None | $54.95 | $54.95 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $67.61 | Professional | None | $53.70 | $58.88 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $125.89 Typical High $165.96 | Facility | None | $77.62 | $125.89 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $95.50 | Professional | None | $53.70 | $61.66 | $95.50 |
DeanCare Setting Facility Modifier None Typical Low $7.08 Median $48.98 Typical High $48.98 | Facility | None | $7.08 | $48.98 | $48.98 |
DeanCare Setting Professional Modifier None Typical Low $4.27 Median $97.72 Typical High $97.72 | Professional | None | $4.27 | $97.72 | $97.72 |
Medica Setting Facility Modifier None Typical Low $7.08 Median $46.77 Typical High $46.77 | Facility | None | $7.08 | $46.77 | $46.77 |
Medica Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $70.79 | Professional | None | $46.77 | $46.77 | $70.79 |
Network Health Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Prevea360 Setting Facility Modifier None Typical Low $7.08 Median $48.98 Typical High $48.98 | Facility | None | $7.08 | $48.98 | $48.98 |
Prevea360 Setting Professional Modifier None Typical Low $4.27 Median $97.72 Typical High $97.72 | Professional | None | $4.27 | $97.72 | $97.72 |
Quartz Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $125.89 | Professional | None | $53.70 | $77.62 | $125.89 |
Quartz Setting Facility Modifier None Typical Low $70.79 Median $165.96 Typical High $165.96 | Facility | None | $70.79 | $165.96 | $165.96 |
Quartz Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Security Health Setting Professional Modifier None Typical Low $23.44 Median $72.44 Typical High $89.13 | Professional | None | $23.44 | $72.44 | $89.13 |
United Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
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 $27.54 Median $27.54 Typical High $38.02 | Professional | 52 · Reduced service | $27.54 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $15.14 | Professional | 53 · Discontinued | $10.96 | $10.96 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $11.48 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $7.59 |
Where Wisconsin sits
The same service costs 3.0 times more in Arizona 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· 7th of 51
$58.88
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.