How much rates vary
Facilitymedian $17 · 10th to 90th $8 to $43Professionalmedian $8 · 10th to 90th $5 to $27
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 $8.32 Median $8.32 Typical High $16.60 | Facility | None | $8.32 | $8.32 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.32 Typical High $57.54 | Professional | None | $8.13 | $8.32 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $12.30 | Professional | None | $8.13 | $8.13 | $12.30 |
CareSource Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $11.75 | Professional | None | $7.59 | $7.59 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $17.38 Typical High $24.55 | Facility | None | $10.72 | $17.38 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $11.48 | Professional | None | $8.13 | $8.13 | $11.48 |
DeanCare Setting Facility Modifier None Typical Low $2.95 Median $7.59 Typical High $16.98 | Facility | None | $2.95 | $7.59 | $16.98 |
DeanCare Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $15.14 | Professional | None | $3.39 | $3.39 | $15.14 |
Medica Setting Facility Modifier None Typical Low $5.37 Median $38.90 Typical High $48.98 | Facility | None | $5.37 | $38.90 | $48.98 |
Medica Setting Professional Modifier None Typical Low $5.37 Median $6.92 Typical High $48.98 | Professional | None | $5.37 | $6.92 | $48.98 |
Network Health Setting Facility Modifier None Typical Low $6.92 Median $10.96 Typical High $10.96 | Facility | None | $6.92 | $10.96 | $10.96 |
Network Health Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $4.47 | Professional | None | $3.63 | $3.63 | $4.47 |
Prevea360 Setting Facility Modifier None Typical Low $2.95 Median $7.59 Typical High $16.98 | Facility | None | $2.95 | $7.59 | $16.98 |
Prevea360 Setting Professional Modifier None Typical Low $0.79 Median $15.14 Typical High $15.14 | Professional | None | $0.79 | $15.14 | $15.14 |
Quartz Setting Professional Modifier None Typical Low $5.62 Median $11.48 Typical High $19.50 | Professional | None | $5.62 | $11.48 | $19.50 |
Quartz Setting Facility Modifier None Typical Low $10.72 Median $24.55 Typical High $24.55 | Facility | None | $10.72 | $24.55 | $24.55 |
Quartz Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Security Health Setting Professional Modifier None Typical Low $5.37 Median $10.23 Typical High $11.22 | Professional | None | $5.37 | $10.23 | $11.22 |
The Alliance Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $19.05 | Professional | None | $7.08 | $7.08 | $19.05 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $9.77 | Professional | None | $7.24 | $7.24 | $9.77 |
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 $4.07 Median $4.17 Typical High $31.62 | Professional | 52 · Reduced service | $4.07 | $4.17 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.66 Typical High $12.59 | Professional | 53 · Discontinued | $1.62 | $1.66 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.26 Typical High $9.33 | Professional | 55 · Aftercare only | $1.23 | $1.26 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.83 Typical High $6.31 | Professional | 56 · Pre-op care only | $0.81 | $0.83 | $6.31 |
Where Wisconsin sits
Rates are fairly even across states for this service. 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· 13th of 51
$8.13
AK $10.72NC $7.24
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.