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 $56.23 Median $56.23 Typical High $125.89 | Facility | None | $56.23 | $56.23 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $416.87 | Professional | None | $56.23 | $56.23 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $69.18 | Professional | None | $54.95 | $60.26 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $141.25 Typical High $165.96 | Facility | None | $85.11 | $141.25 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $104.71 | Professional | None | $54.95 | $70.79 | $104.71 |
DeanCare Setting Facility Modifier None Typical Low $30.20 Median $60.26 Typical High $63.10 | Facility | None | $30.20 | $60.26 | $63.10 |
DeanCare Setting Professional Modifier None Typical Low $16.60 Median $120.23 Typical High $120.23 | Professional | None | $16.60 | $120.23 | $120.23 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $97.72 Typical High $208.93 | Facility | None | $30.20 | $97.72 | $208.93 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $134.90 | Professional | None | $97.72 | $97.72 | $134.90 |
Network Health Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $81.28 | Facility | None | $44.67 | $44.67 | $81.28 |
Prevea360 Setting Facility Modifier None Typical Low $30.20 Median $60.26 Typical High $63.10 | Facility | None | $30.20 | $60.26 | $63.10 |
Prevea360 Setting Professional Modifier None Typical Low $16.60 Median $120.23 Typical High $120.23 | Professional | None | $16.60 | $120.23 | $120.23 |
Quartz Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $190.55 | Professional | None | $54.95 | $87.10 | $190.55 |
Quartz Setting Facility Modifier None Typical Low $72.44 Median $165.96 Typical High $165.96 | Facility | None | $72.44 | $165.96 | $165.96 |
Quartz Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Security Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $91.20 | Professional | None | $74.13 | $74.13 | $91.20 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
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 $28.18 Median $28.18 Typical High $208.93 | Professional | 52 · Reduced service | $28.18 | $28.18 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $85.11 | Professional | 53 · Discontinued | $11.22 | $11.22 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $63.10 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $41.69 |
Where Wisconsin sits
The same service costs 2.7 times more in Oklahoma than in West Virginia. 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· 8th of 51
$69.18
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.