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 $14.45 Median $14.45 Typical High $31.62 | Facility | None | $14.45 | $14.45 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $107.15 | Professional | None | $14.45 | $14.45 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $30.20 | Facility | None | $17.38 | $17.38 | $30.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $17.78 | Professional | None | $14.13 | $15.49 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $21.88 Typical High $42.66 | Facility | None | $14.79 | $21.88 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $17.38 Typical High $27.54 | Professional | None | $14.13 | $17.38 | $27.54 |
DeanCare Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $31.62 | Facility | None | $14.13 | $14.13 | $31.62 |
DeanCare Setting Professional Modifier None Typical Low $21.38 Median $28.18 Typical High $28.18 | Professional | None | $21.38 | $28.18 | $28.18 |
Medica Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $31.62 | Facility | None | $14.13 | $14.13 | $31.62 |
Medica Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $24.55 | Professional | None | $14.13 | $15.85 | $24.55 |
Network Health Setting Facility Modifier None Typical Low $13.49 Median $14.79 Typical High $14.79 | Facility | None | $13.49 | $14.79 | $14.79 |
Prevea360 Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $31.62 | Facility | None | $14.13 | $14.13 | $31.62 |
Prevea360 Setting Professional Modifier None Typical Low $21.38 Median $28.18 Typical High $28.18 | Professional | None | $21.38 | $28.18 | $28.18 |
Quartz Setting Professional Modifier None Typical Low $14.13 Median $22.39 Typical High $36.31 | Professional | None | $14.13 | $22.39 | $36.31 |
Quartz Setting Facility Modifier None Typical Low $18.62 Median $42.66 Typical High $42.66 | Facility | None | $18.62 | $42.66 | $42.66 |
Quartz Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Security Health Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $23.44 | Professional | None | $19.05 | $19.05 | $23.44 |
United Setting Professional Modifier None Typical Low $13.80 Median $15.49 Typical High $18.62 | Professional | None | $13.80 | $15.49 | $18.62 |
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 $7.24 Median $7.24 Typical High $53.70 | Professional | 52 · Reduced service | $7.24 | $7.24 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $21.38 | Professional | 53 · Discontinued | $2.88 | $2.88 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $16.22 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $10.72 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $10.72 |
Where Wisconsin sits
The same service costs 1.8 times more in Alaska than in Virginia. 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
$15.85
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.