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 $1.02 Median $1.02 Typical High $2.29 | Facility | None | $1.02 | $1.02 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.21 Typical High $5.01 | Professional | 53 · Discontinued | $0.21 | $0.21 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $3.72 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $2.51 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $2.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $0.98 | Professional | None | $0.98 | $0.98 | $0.98 |
Cigna Setting Facility Modifier None Typical Low $1.00 Median $1.82 Typical High $2.04 | Facility | None | $1.00 | $1.82 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $0.85 Typical High $0.95 | Professional | None | $0.65 | $0.85 | $0.95 |
DeanCare Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $1.02 | Facility | None | $0.35 | $0.35 | $1.02 |
DeanCare Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Medica Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $1.02 | Facility | None | $0.35 | $0.35 | $1.02 |
Medica Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.49 | Professional | None | $0.36 | $0.36 | $0.49 |
Prevea360 Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $1.02 | Facility | None | $0.35 | $0.35 | $1.02 |
Prevea360 Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Quartz Setting Facility Modifier None Typical Low $0.85 Median $2.00 Typical High $2.00 | Facility | None | $0.85 | $2.00 | $2.00 |
Quartz Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Security Health Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.49 | Professional | None | $0.36 | $0.36 | $0.49 |
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 $0.52 Median $0.52 Typical High $0.52 | Professional | 52 · Reduced service | $0.52 | $0.52 | $0.52 |
Where Wisconsin sits
The same service costs 27.5 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· 38th 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.