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 $1.95 Median $1.95 Typical High $5.01 | Facility | None | $1.95 | $1.95 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.91 Median $2.09 Typical High $2.88 | Professional | None | $1.91 | $2.09 | $2.88 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $5.37 Typical High $6.03 | Facility | None | $2.95 | $5.37 | $6.03 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.45 Typical High $3.98 | Professional | None | $1.91 | $2.45 | $3.98 |
DeanCare Setting Facility Modifier None Typical Low $1.32 Median $2.51 Typical High $5.75 | Facility | None | $1.32 | $2.51 | $5.75 |
DeanCare Setting Professional Modifier None Typical Low $3.80 Median $5.13 Typical High $5.13 | Professional | None | $3.80 | $5.13 | $5.13 |
Medica Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $13.18 | Facility | None | $1.95 | $1.95 | $13.18 |
Medica Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $5.13 | Professional | None | $1.95 | $1.95 | $5.13 |
Network Health Setting Facility Modifier None Typical Low $0.95 Median $0.95 Typical High $7.59 | Facility | None | $0.95 | $0.95 | $7.59 |
Prevea360 Setting Facility Modifier None Typical Low $1.32 Median $2.51 Typical High $5.75 | Facility | None | $1.32 | $2.51 | $5.75 |
Prevea360 Setting Professional Modifier None Typical Low $3.80 Median $5.13 Typical High $5.13 | Professional | None | $3.80 | $5.13 | $5.13 |
Quartz Setting Professional Modifier None Typical Low $1.91 Median $3.47 Typical High $6.76 | Professional | None | $1.91 | $3.47 | $6.76 |
Quartz Setting Facility Modifier None Typical Low $2.51 Median $5.89 Typical High $5.89 | Facility | None | $2.51 | $5.89 | $5.89 |
Quartz Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
Security Health Setting Professional Modifier None Typical Low $1.55 Median $2.57 Typical High $3.16 | Professional | None | $1.55 | $2.57 | $3.16 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.95 | Professional | None | $2.14 | $2.14 | $2.95 |
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 $1.00 Median $1.00 Typical High $16.98 | Professional | 52 · Reduced service | $1.00 | $1.00 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.39 Typical High $6.76 | Professional | 53 · Discontinued | $0.39 | $0.39 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.30 Typical High $5.13 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $3.39 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $3.39 |
Where Wisconsin sits
The same service costs 2.5 times more in Texas than in South Carolina. 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
$2.29
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.