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 $0.78 Median $0.78 Typical High $1.58 | Facility | None | $0.78 | $0.78 | $1.58 |
Aetna Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $6.03 | Professional | None | $0.78 | $0.78 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.93 Median $0.93 Typical High $0.93 | Facility | None | $0.93 | $0.93 | $0.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.76 Median $0.81 Typical High $0.95 | Professional | None | $0.76 | $0.81 | $0.95 |
Cigna Setting Facility Modifier None Typical Low $1.05 Median $1.70 Typical High $2.29 | Facility | None | $1.05 | $1.70 | $2.29 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.98 Typical High $1.32 | Professional | None | $0.76 | $0.98 | $1.32 |
DeanCare Setting Facility Modifier None Typical Low $0.66 Median $0.76 Typical High $1.41 | Facility | None | $0.66 | $0.76 | $1.41 |
DeanCare Setting Professional Modifier None Typical Low $0.54 Median $1.51 Typical High $1.51 | Professional | None | $0.54 | $1.51 | $1.51 |
Medica Setting Facility Modifier None Typical Low $0.59 Median $2.24 Typical High $6.92 | Facility | None | $0.59 | $2.24 | $6.92 |
Medica Setting Professional Modifier None Typical Low $0.89 Median $1.00 Typical High $1.51 | Professional | None | $0.89 | $1.00 | $1.51 |
Network Health Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $1.74 | Facility | None | $0.85 | $0.85 | $1.74 |
Prevea360 Setting Facility Modifier None Typical Low $0.66 Median $0.76 Typical High $1.41 | Facility | None | $0.66 | $0.76 | $1.41 |
Prevea360 Setting Professional Modifier None Typical Low $0.54 Median $1.51 Typical High $1.51 | Professional | None | $0.54 | $1.51 | $1.51 |
Quartz Setting Professional Modifier None Typical Low $0.76 Median $1.10 Typical High $1.74 | Professional | None | $0.76 | $1.10 | $1.74 |
Quartz Setting Facility Modifier None Typical Low $1.00 Median $2.29 Typical High $2.29 | Facility | None | $1.00 | $2.29 | $2.29 |
Quartz Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Security Health Setting Professional Modifier None Typical Low $0.58 Median $1.00 Typical High $1.26 | Professional | None | $0.58 | $1.00 | $1.26 |
United Setting Professional Modifier None Typical Low $0.69 Median $0.76 Typical High $1.02 | Professional | None | $0.69 | $0.76 | $1.02 |
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 $0.39 Median $0.39 Typical High $3.47 | Professional | 52 · Reduced service | $0.39 | $0.39 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $1.41 | Professional | 53 · Discontinued | $0.15 | $0.15 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $1.05 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.71 |
Where Wisconsin sits
The same service costs 5.2 times more in Vermont 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· 13th of 51
$0.89
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.