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 $3.55 Median $3.55 Typical High $7.41 | Facility | None | $3.55 | $3.55 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $5.01 | Professional | None | $3.55 | $3.55 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $6.92 | Facility | None | $4.37 | $4.37 | $6.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.80 Typical High $5.25 | Professional | None | $3.47 | $3.80 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $7.94 Typical High $10.47 | Facility | None | $4.79 | $7.94 | $10.47 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $4.37 Typical High $6.03 | Professional | None | $3.47 | $4.37 | $6.03 |
DeanCare Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $7.08 | Facility | None | $3.24 | $3.24 | $7.08 |
DeanCare Setting Professional Modifier None Typical Low $4.90 Median $6.46 Typical High $6.46 | Professional | None | $4.90 | $6.46 | $6.46 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $7.08 | Facility | None | $3.24 | $3.24 | $7.08 |
Medica Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.90 | Professional | None | $3.24 | $3.24 | $4.90 |
Network Health Setting Facility Modifier None Typical Low $3.16 Median $3.31 Typical High $3.31 | Facility | None | $3.16 | $3.31 | $3.31 |
Prevea360 Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $7.08 | Facility | None | $3.24 | $3.24 | $7.08 |
Prevea360 Setting Professional Modifier None Typical Low $4.90 Median $6.46 Typical High $6.46 | Professional | None | $4.90 | $6.46 | $6.46 |
Quartz Setting Professional Modifier None Typical Low $3.47 Median $5.25 Typical High $8.51 | Professional | None | $3.47 | $5.25 | $8.51 |
Quartz Setting Facility Modifier None Typical Low $4.57 Median $10.47 Typical High $10.47 | Facility | None | $4.57 | $10.47 | $10.47 |
Quartz Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Security Health Setting Professional Modifier None Typical Low $4.27 Median $4.68 Typical High $5.75 | Professional | None | $4.27 | $4.68 | $5.75 |
United Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.47 | Professional | None | $3.24 | $3.24 | $4.47 |
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 $1.78 Median $1.78 Typical High $2.51 | Professional | 52 · Reduced service | $1.78 | $1.78 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $1.00 | Professional | 53 · Discontinued | $0.71 | $0.71 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.76 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.50 |
Where Wisconsin sits
The same service costs 2.1 times more in Alaska 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· 8th of 51
$3.98
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.