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 $0.55 Median $0.55 Typical High $1.26 | Facility | None | $0.55 | $0.55 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $8.91 | Professional | None | $0.55 | $0.55 | $8.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Facility | None | $0.68 | $0.68 | $0.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.54 Median $0.59 Typical High $0.79 | Professional | None | $0.54 | $0.59 | $0.79 |
Cigna Setting Facility Modifier None Typical Low $0.78 Median $1.26 Typical High $1.66 | Facility | None | $0.78 | $1.26 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $0.54 Median $0.71 Typical High $1.00 | Professional | None | $0.54 | $0.71 | $1.00 |
DeanCare Setting Facility Modifier None Typical Low $0.59 Median $0.59 Typical High $6.31 | Facility | None | $0.59 | $0.59 | $6.31 |
DeanCare Setting Professional Modifier None Typical Low $0.89 Median $1.17 Typical High $3.98 | Professional | None | $0.89 | $1.17 | $3.98 |
Medica Setting Facility Modifier None Typical Low $0.56 Median $2.63 Typical High $8.91 | Facility | None | $0.56 | $2.63 | $8.91 |
Medica Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $1.17 | Professional | None | $0.56 | $0.56 | $1.17 |
Network Health Setting Facility Modifier None Typical Low $0.72 Median $0.72 Typical High $0.72 | Facility | None | $0.72 | $0.72 | $0.72 |
Prevea360 Setting Facility Modifier None Typical Low $0.59 Median $0.59 Typical High $6.31 | Facility | None | $0.59 | $0.59 | $6.31 |
Prevea360 Setting Professional Modifier None Typical Low $0.89 Median $1.17 Typical High $3.98 | Professional | None | $0.89 | $1.17 | $3.98 |
Quartz Setting Professional Modifier None Typical Low $0.54 Median $0.89 Typical High $1.74 | Professional | None | $0.54 | $0.89 | $1.74 |
Quartz Setting Facility Modifier None Typical Low $0.72 Median $1.66 Typical High $1.66 | Facility | None | $0.72 | $1.66 | $1.66 |
Quartz Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Security Health Setting Professional Modifier None Typical Low $0.72 Median $0.76 Typical High $1.20 | Professional | None | $0.72 | $0.76 | $1.20 |
United Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.74 | Professional | None | $0.54 | $0.54 | $0.74 |
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 $0.28 Median $0.28 Typical High $4.47 | Professional | 52 · Reduced service | $0.28 | $0.28 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $1.82 | Professional | 53 · Discontinued | $0.11 | $0.11 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $1.35 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.89 |
Where Wisconsin sits
The same service costs 6.3 times more in Texas than in Mississippi. 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· 16th of 51
$0.65
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.