How much rates vary
Facilitymedian $17 · 10th to 90th $11 to $34Professionalmedian $12 · 10th to 90th $11 to $26
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 $11.48 Median $11.48 Typical High $25.70 | Facility | None | $11.48 | $11.48 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $69.18 | Professional | None | $11.48 | $11.48 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $24.55 | Facility | None | $13.80 | $13.80 | $24.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $12.02 Typical High $14.13 | Professional | None | $10.96 | $12.02 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $17.38 Typical High $33.88 | Facility | None | $11.48 | $17.38 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $14.13 Typical High $21.38 | Professional | None | $10.96 | $14.13 | $21.38 |
DeanCare Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $23.99 | Facility | None | $10.96 | $10.96 | $23.99 |
DeanCare Setting Professional Modifier None Typical Low $16.60 Median $21.88 Typical High $21.88 | Professional | None | $16.60 | $21.88 | $21.88 |
Medica Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $23.99 | Facility | None | $10.96 | $10.96 | $23.99 |
Medica Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $21.88 | Professional | None | $10.96 | $10.96 | $21.88 |
Network Health Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $14.79 | Facility | None | $13.18 | $13.18 | $14.79 |
Prevea360 Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $23.99 | Facility | None | $10.96 | $10.96 | $23.99 |
Prevea360 Setting Professional Modifier None Typical Low $16.60 Median $21.88 Typical High $21.88 | Professional | None | $16.60 | $21.88 | $21.88 |
Quartz Setting Professional Modifier None Typical Low $10.96 Median $18.20 Typical High $44.67 | Professional | None | $10.96 | $18.20 | $44.67 |
Quartz Setting Facility Modifier None Typical Low $14.79 Median $33.88 Typical High $33.88 | Facility | None | $14.79 | $33.88 | $33.88 |
Quartz Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Security Health Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $24.55 | Professional | None | $14.79 | $14.79 | $24.55 |
United Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $15.49 | Professional | None | $11.22 | $11.22 | $15.49 |
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 $5.75 Median $5.75 Typical High $45.71 | Professional | 52 · Reduced service | $5.75 | $5.75 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $18.20 | Professional | 53 · Discontinued | $2.29 | $2.29 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $13.80 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $9.12 |
Where Wisconsin sits
The same service costs 3.7 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· 15th of 51
$12.59
WY $40.74GA $10.96
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.