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 $5.62 Median $5.62 Typical High $12.59 | Facility | None | $5.62 | $5.62 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $25.12 | Professional | None | $5.62 | $5.62 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $8.32 Typical High $19.95 | Professional | None | $3.63 | $8.32 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $15.49 Typical High $18.62 | Facility | None | $9.33 | $15.49 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $6.31 Typical High $7.94 | Professional | None | $6.17 | $6.31 | $7.94 |
DeanCare Setting Facility Modifier None Typical Low $3.63 Median $6.17 Typical High $6.17 | Facility | None | $3.63 | $6.17 | $6.17 |
DeanCare Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $9.33 | Professional | None | $3.47 | $3.47 | $9.33 |
Medica Setting Facility Modifier None Typical Low $3.63 Median $6.17 Typical High $6.17 | Facility | None | $3.63 | $6.17 | $6.17 |
Medica Setting Professional Modifier None Typical Low $12.30 Median $13.49 Typical High $16.98 | Professional | None | $12.30 | $13.49 | $16.98 |
Network Health Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Prevea360 Setting Facility Modifier None Typical Low $3.63 Median $6.17 Typical High $6.17 | Facility | None | $3.63 | $6.17 | $6.17 |
Prevea360 Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $9.33 | Professional | None | $3.47 | $3.47 | $9.33 |
Quartz Setting Professional Modifier None Typical Low $4.07 Median $7.76 Typical High $11.48 | Professional | None | $4.07 | $7.76 | $11.48 |
Quartz Setting Facility Modifier None Typical Low $8.13 Median $18.62 Typical High $18.62 | Facility | None | $8.13 | $18.62 | $18.62 |
Quartz Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Security Health Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $12.30 | Professional | None | $6.61 | $6.61 | $12.30 |
United Setting Professional Modifier None Typical Low $12.30 Median $12.59 Typical High $17.78 | Professional | None | $12.30 | $12.59 | $17.78 |
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 $2.82 Median $2.82 Typical High $12.59 | Professional | 52 · Reduced service | $2.82 | $2.82 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $5.01 | Professional | 53 · Discontinued | $1.12 | $1.12 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $3.72 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $2.51 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $2.51 |
Where Wisconsin sits
The same service costs 2.1 times more in Iowa 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· 11th of 51
$9.33
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.