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 $23.44 Median $23.44 Typical High $52.48 | Facility | None | $23.44 | $23.44 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $169.82 | Professional | None | $23.44 | $23.44 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $25.12 Typical High $33.88 | Professional | None | $22.39 | $25.12 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $57.54 Typical High $69.18 | Facility | None | $34.67 | $57.54 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $31.62 Typical High $42.66 | Professional | None | $22.39 | $31.62 | $42.66 |
DeanCare Setting Facility Modifier None Typical Low $19.05 Median $23.44 Typical High $52.48 | Facility | None | $19.05 | $23.44 | $52.48 |
DeanCare Setting Professional Modifier None Typical Low $3.98 Median $46.77 Typical High $46.77 | Professional | None | $3.98 | $46.77 | $46.77 |
Medica Setting Facility Modifier None Typical Low $19.05 Median $24.55 Typical High $53.70 | Facility | None | $19.05 | $24.55 | $53.70 |
Medica Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $43.65 | Professional | None | $24.55 | $24.55 | $43.65 |
Network Health Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Prevea360 Setting Facility Modifier None Typical Low $19.05 Median $23.44 Typical High $52.48 | Facility | None | $19.05 | $23.44 | $52.48 |
Prevea360 Setting Professional Modifier None Typical Low $3.98 Median $46.77 Typical High $46.77 | Professional | None | $3.98 | $46.77 | $46.77 |
Quartz Setting Professional Modifier None Typical Low $22.39 Median $37.15 Typical High $60.26 | Professional | None | $22.39 | $37.15 | $60.26 |
Quartz Setting Facility Modifier None Typical Low $30.20 Median $69.18 Typical High $69.18 | Facility | None | $30.20 | $69.18 | $69.18 |
Quartz Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Security Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $37.15 | Professional | None | $30.20 | $30.20 | $37.15 |
United Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $31.62 | Professional | None | $22.91 | $22.91 | $31.62 |
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 $11.75 Median $11.75 Typical High $83.18 | Professional | 52 · Reduced service | $11.75 | $11.75 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $33.88 | Professional | 53 · Discontinued | $4.68 | $4.68 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $25.12 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $16.98 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $16.98 |
Where Wisconsin sits
The same service costs 1.9 times more in Alaska than in Mississippi. 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· 9th of 51
$26.92
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.