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 $3.39 Median $3.39 Typical High $7.24 | Facility | None | $3.39 | $3.39 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $25.12 | Professional | None | $3.39 | $3.39 | $25.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $4.90 | Professional | None | $3.24 | $3.55 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $7.76 Typical High $10.00 | Facility | None | $4.68 | $7.76 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $4.17 Typical High $5.89 | Professional | None | $3.24 | $4.17 | $5.89 |
DeanCare Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $7.08 | Facility | None | $3.09 | $3.09 | $7.08 |
DeanCare Setting Professional Modifier None Typical Low $4.68 Median $6.17 Typical High $6.17 | Professional | None | $4.68 | $6.17 | $6.17 |
Medica Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $6.46 | Facility | None | $3.02 | $3.02 | $6.46 |
Medica Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $4.57 | Professional | None | $3.02 | $3.02 | $4.57 |
Network Health Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Prevea360 Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $7.08 | Facility | None | $3.09 | $3.09 | $7.08 |
Prevea360 Setting Professional Modifier None Typical Low $4.68 Median $6.17 Typical High $6.17 | Professional | None | $4.68 | $6.17 | $6.17 |
Quartz Setting Professional Modifier None Typical Low $3.24 Median $5.13 Typical High $7.76 | Professional | None | $3.24 | $5.13 | $7.76 |
Quartz Setting Facility Modifier None Typical Low $4.37 Median $10.00 Typical High $10.00 | Facility | None | $4.37 | $10.00 | $10.00 |
Quartz Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Security Health Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $5.37 | Professional | None | $4.37 | $4.37 | $5.37 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $4.37 | Professional | None | $3.16 | $3.16 | $4.37 |
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 $1.70 Median $1.70 Typical High $12.59 | Professional | 52 · Reduced service | $1.70 | $1.70 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $5.01 | Professional | 53 · Discontinued | $0.68 | $0.68 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.50 Typical High $3.72 | Professional | 55 · Aftercare only | $0.50 | $0.50 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $2.51 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $2.51 |
Where Wisconsin sits
The same service costs 2.0 times more in Arizona than in Oklahoma. 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· 7th of 51
$3.72
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.