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 $42.66 Median $42.66 Typical High $91.20 | Facility | None | $42.66 | $42.66 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $131.83 | Professional | None | $42.66 | $42.66 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $85.11 | Facility | None | $51.29 | $51.29 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $61.66 | Professional | None | $41.69 | $45.71 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $69.18 Typical High $125.89 | Facility | None | $41.69 | $69.18 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $74.13 | Professional | None | $41.69 | $45.71 | $74.13 |
DeanCare Setting Facility Modifier None Typical Low $26.30 Median $39.81 Typical High $39.81 | Facility | None | $26.30 | $39.81 | $39.81 |
DeanCare Setting Professional Modifier None Typical Low $16.98 Median $79.43 Typical High $79.43 | Professional | None | $16.98 | $79.43 | $79.43 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $39.81 Typical High $39.81 | Facility | None | $26.30 | $39.81 | $39.81 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $60.26 | Professional | None | $39.81 | $39.81 | $60.26 |
Network Health Setting Facility Modifier None Typical Low $38.02 Median $39.81 Typical High $58.88 | Facility | None | $38.02 | $39.81 | $58.88 |
Prevea360 Setting Facility Modifier None Typical Low $26.30 Median $39.81 Typical High $39.81 | Facility | None | $26.30 | $39.81 | $39.81 |
Prevea360 Setting Professional Modifier None Typical Low $16.98 Median $79.43 Typical High $79.43 | Professional | None | $16.98 | $79.43 | $79.43 |
Quartz Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $100.00 | Professional | None | $41.69 | $63.10 | $100.00 |
Quartz Setting Facility Modifier None Typical Low $54.95 Median $125.89 Typical High $125.89 | Facility | None | $54.95 | $125.89 | $125.89 |
Quartz Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Security Health Setting Professional Modifier None Typical Low $33.11 Median $56.23 Typical High $69.18 | Professional | None | $33.11 | $56.23 | $69.18 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
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 $6.46 Median $6.46 Typical High $19.50 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $13.18 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $13.18 |
Where Wisconsin sits
The same service costs 1.7 times more in Arizona than in Nebraska. 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
$47.86
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.