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 $20.89 Median $20.89 Typical High $74.13 | Facility | None | $20.89 | $20.89 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $181.97 | Professional | None | $20.89 | $20.89 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $69.18 | Facility | None | $25.70 | $25.70 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $22.39 Typical High $30.20 | Professional | None | $20.42 | $22.39 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $57.54 Typical High $107.15 | Facility | None | $31.62 | $57.54 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $36.31 Typical High $70.79 | Professional | None | $20.42 | $36.31 | $70.79 |
DeanCare Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $66.07 | Facility | None | $29.51 | $29.51 | $66.07 |
DeanCare Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $60.26 | Professional | None | $44.67 | $60.26 | $60.26 |
Medica Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $53.70 | Facility | None | $24.55 | $24.55 | $53.70 |
Medica Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $60.26 | Professional | None | $24.55 | $24.55 | $60.26 |
Network Health Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $64.57 | Facility | None | $51.29 | $51.29 | $64.57 |
Prevea360 Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $66.07 | Facility | None | $29.51 | $29.51 | $66.07 |
Prevea360 Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $60.26 | Professional | None | $44.67 | $60.26 | $60.26 |
Quartz Setting Professional Modifier None Typical Low $20.42 Median $51.29 Typical High $123.03 | Professional | None | $20.42 | $51.29 | $123.03 |
Quartz Setting Facility Modifier None Typical Low $33.88 Median $61.66 Typical High $61.66 | Facility | None | $33.88 | $61.66 | $61.66 |
Quartz Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Security Health Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $33.88 | Professional | None | $27.54 | $27.54 | $33.88 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $43.65 | Professional | None | $32.36 | $32.36 | $43.65 |
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 $10.47 Median $10.47 Typical High $138.04 | Professional | 52 · Reduced service | $10.47 | $10.47 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $54.95 | Professional | 53 · Discontinued | $4.17 | $4.17 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $40.74 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $27.54 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $27.54 |
Where Wisconsin sits
The same service costs 3.8 times more in Oklahoma than in Delaware. 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
$27.54
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.