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 $13.18 Median $13.18 Typical High $28.84 | Facility | None | $13.18 | $13.18 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $56.23 | Professional | None | $13.18 | $13.18 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $26.92 | Facility | None | $16.22 | $16.22 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $16.22 | Professional | None | $12.88 | $14.13 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $30.90 Typical High $38.90 | Facility | None | $19.05 | $30.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $16.60 Typical High $23.44 | Professional | None | $12.88 | $16.60 | $23.44 |
DeanCare Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $26.92 | Facility | None | $12.30 | $12.30 | $26.92 |
DeanCare Setting Professional Modifier None Typical Low $18.62 Median $24.55 Typical High $24.55 | Professional | None | $18.62 | $24.55 | $24.55 |
Medica Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $26.92 | Facility | None | $12.30 | $12.30 | $26.92 |
Medica Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $18.62 | Professional | None | $12.30 | $12.30 | $18.62 |
Network Health Setting Facility Modifier None Typical Low $12.59 Median $12.88 Typical High $12.88 | Facility | None | $12.59 | $12.88 | $12.88 |
Prevea360 Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $26.92 | Facility | None | $12.30 | $12.30 | $26.92 |
Prevea360 Setting Professional Modifier None Typical Low $18.62 Median $24.55 Typical High $24.55 | Professional | None | $18.62 | $24.55 | $24.55 |
Quartz Setting Professional Modifier None Typical Low $12.88 Median $19.95 Typical High $31.62 | Professional | None | $12.88 | $19.95 | $31.62 |
Quartz Setting Facility Modifier None Typical Low $16.98 Median $38.90 Typical High $38.90 | Facility | None | $16.98 | $38.90 | $38.90 |
Quartz Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Security Health Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $21.38 | Professional | None | $17.38 | $17.38 | $21.38 |
United Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $17.38 | Professional | None | $12.59 | $12.59 | $17.38 |
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 $6.61 Median $6.61 Typical High $28.18 | Professional | 52 · Reduced service | $6.61 | $6.61 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $11.22 | Professional | 53 · Discontinued | $2.63 | $2.63 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $8.32 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $5.62 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $5.62 |
Where Wisconsin sits
The same service costs 1.5 times more in Alaska than in Maryland. 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· 9th of 51
$14.79
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.