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 $2.09 Median $2.09 Typical High $4.68 | Facility | None | $2.09 | $2.09 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.42 Typical High $10.00 | Professional | 53 · Discontinued | $0.42 | $0.42 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $7.59 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $5.01 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $5.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $3.31 Median $5.37 Typical High $6.76 | Facility | None | $3.31 | $5.37 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.51 Typical High $3.02 | Professional | None | $2.24 | $2.51 | $3.02 |
DeanCare Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
DeanCare Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Medica Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
Medica Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $3.09 | Professional | None | $2.24 | $2.24 | $3.09 |
Prevea360 Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
Prevea360 Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Quartz Setting Facility Modifier None Typical Low $2.95 Median $6.76 Typical High $6.76 | Facility | None | $2.95 | $6.76 | $6.76 |
Quartz Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Security Health Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.98 | Professional | None | $2.14 | $2.14 | $3.98 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $3.09 | Professional | None | $2.24 | $2.24 | $3.09 |
1 more rate 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 $1.07 Median $1.07 Typical High $1.07 | Professional | 52 · Reduced service | $1.07 | $1.07 | $1.07 |
Where Wisconsin sits
The same service costs 128.8 times more in Kansas than in New York. 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· 33rd of 51
$2.24
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.