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 $3.16 Median $3.16 Typical High $7.24 | Facility | None | $3.16 | $3.16 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $15.85 | Professional | None | $3.16 | $3.16 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.55 Typical High $8.91 | Professional | None | $3.09 | $3.55 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $7.76 Typical High $9.33 | Facility | None | $4.79 | $7.76 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $3.89 Typical High $5.89 | Professional | None | $3.09 | $3.89 | $5.89 |
DeanCare Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $10.00 | Facility | None | $3.16 | $3.16 | $10.00 |
DeanCare Setting Professional Modifier None Typical Low $1.86 Median $6.31 Typical High $6.31 | Professional | None | $1.86 | $6.31 | $6.31 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $10.00 | Facility | None | $3.24 | $3.24 | $10.00 |
Medica Setting Professional Modifier None Typical Low $1.29 Median $3.24 Typical High $4.47 | Professional | None | $1.29 | $3.24 | $4.47 |
Network Health Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Network Health Setting Professional Modifier None Typical Low $2.24 Median $2.51 Typical High $2.88 | Professional | None | $2.24 | $2.51 | $2.88 |
Prevea360 Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $10.00 | Facility | None | $3.16 | $3.16 | $10.00 |
Prevea360 Setting Professional Modifier None Typical Low $1.86 Median $6.31 Typical High $6.31 | Professional | None | $1.86 | $6.31 | $6.31 |
Quartz Setting Professional Modifier None Typical Low $3.09 Median $5.01 Typical High $18.62 | Professional | None | $3.09 | $5.01 | $18.62 |
Quartz Setting Facility Modifier None Typical Low $4.07 Median $9.33 Typical High $9.33 | Facility | None | $4.07 | $9.33 | $9.33 |
Quartz Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
Security Health Setting Professional Modifier None Typical Low $4.17 Median $5.13 Typical High $13.80 | Professional | None | $4.17 | $5.13 | $13.80 |
United Setting Professional Modifier None Typical Low $1.26 Median $3.16 Typical High $4.27 | Professional | None | $1.26 | $3.16 | $4.27 |
2 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 55 · Aftercare only Typical Low $0.47 Median $0.47 Typical High $2.40 | Professional | 55 · Aftercare only | $0.47 | $0.47 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $1.58 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $1.58 |
Where Wisconsin sits
The same service costs 3.5 times more in Oklahoma than in Virginia. 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· 5th of 51
$3.39
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.