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 $32.36 Median $32.36 Typical High $77.62 | Facility | None | $32.36 | $32.36 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $338.84 | Professional | None | $32.36 | $32.36 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $39.81 | Professional | None | $31.62 | $34.67 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $81.28 Typical High $95.50 | Facility | None | $48.98 | $81.28 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $45.71 Typical High $61.66 | Professional | None | $31.62 | $45.71 | $61.66 |
DeanCare Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $87.10 | Facility | None | $39.81 | $39.81 | $87.10 |
DeanCare Setting Professional Modifier None Typical Low $30.20 Median $79.43 Typical High $79.43 | Professional | None | $30.20 | $79.43 | $79.43 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $87.10 | Facility | None | $39.81 | $39.81 | $87.10 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $79.43 | Professional | None | $39.81 | $39.81 | $79.43 |
Network Health Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Prevea360 Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $87.10 | Facility | None | $39.81 | $39.81 | $87.10 |
Prevea360 Setting Professional Modifier None Typical Low $30.20 Median $79.43 Typical High $79.43 | Professional | None | $30.20 | $79.43 | $79.43 |
Quartz Setting Professional Modifier None Typical Low $31.62 Median $54.95 Typical High $123.03 | Professional | None | $31.62 | $54.95 | $123.03 |
Quartz Setting Facility Modifier None Typical Low $52.48 Median $95.50 Typical High $95.50 | Facility | None | $52.48 | $95.50 | $95.50 |
Quartz Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Security Health Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $60.26 | Professional | None | $42.66 | $42.66 | $60.26 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
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 $16.22 Median $16.22 Typical High $190.55 | Professional | 52 · Reduced service | $16.22 | $16.22 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $75.86 | Professional | 53 · Discontinued | $6.46 | $6.46 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $56.23 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $38.02 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $38.02 |
Where Wisconsin sits
The same service costs 2.3 times more in Wyoming than in Georgia. 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· 14th of 51
$38.90
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.