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 $28.84 Median $28.84 Typical High $56.23 | Facility | None | $28.84 | $28.84 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $77.62 | Professional | None | $28.84 | $28.84 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $35.48 | Professional | None | $28.18 | $30.90 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $63.10 Typical High $85.11 | Facility | None | $38.02 | $63.10 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $46.77 | Professional | None | $28.18 | $30.20 | $46.77 |
DeanCare Setting Facility Modifier None Typical Low $12.88 Median $19.95 Typical High $43.65 | Facility | None | $12.88 | $19.95 | $43.65 |
DeanCare Setting Professional Modifier None Typical Low $12.30 Median $39.81 Typical High $39.81 | Professional | None | $12.30 | $39.81 | $39.81 |
Medica Setting Facility Modifier None Typical Low $12.88 Median $17.38 Typical High $120.23 | Facility | None | $12.88 | $17.38 | $120.23 |
Medica Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $39.81 | Professional | None | $17.38 | $17.38 | $39.81 |
Network Health Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $58.88 | Facility | None | $29.51 | $29.51 | $58.88 |
Prevea360 Setting Facility Modifier None Typical Low $12.88 Median $19.95 Typical High $43.65 | Facility | None | $12.88 | $19.95 | $43.65 |
Prevea360 Setting Professional Modifier None Typical Low $12.30 Median $39.81 Typical High $39.81 | Professional | None | $12.30 | $39.81 | $39.81 |
Quartz Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $52.48 | Professional | None | $26.30 | $31.62 | $52.48 |
Quartz Setting Facility Modifier None Typical Low $37.15 Median $85.11 Typical High $85.11 | Facility | None | $37.15 | $85.11 | $85.11 |
Quartz Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Security Health Setting Professional Modifier None Typical Low $15.14 Median $38.02 Typical High $46.77 | Professional | None | $15.14 | $38.02 | $46.77 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
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 $14.45 Median $14.45 Typical High $38.90 | Professional | 52 · Reduced service | $14.45 | $14.45 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $15.49 | Professional | 53 · Discontinued | $5.75 | $5.75 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $11.48 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $7.76 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $7.76 |
Where Wisconsin sits
The same service costs 2.2 times more in Alaska 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· 12th of 51
$28.84
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.