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 $46.77 | Facility | None | $20.89 | $20.89 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $58.88 | Professional | None | $20.89 | $20.89 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $46.77 Typical High $112.20 | Professional | None | $20.42 | $46.77 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $52.48 Typical High $64.57 | Facility | None | $31.62 | $52.48 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $26.92 Typical High $39.81 | Professional | None | $20.89 | $26.92 | $39.81 |
DeanCare Setting Facility Modifier None Typical Low $20.42 Median $22.91 Typical High $44.67 | Facility | None | $20.42 | $22.91 | $44.67 |
DeanCare Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Medica Setting Facility Modifier None Typical Low $20.42 Median $22.91 Typical High $44.67 | Facility | None | $20.42 | $22.91 | $44.67 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $28.84 | Professional | None | $20.89 | $20.89 | $28.84 |
Network Health Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Prevea360 Setting Facility Modifier None Typical Low $20.42 Median $22.91 Typical High $44.67 | Facility | None | $20.42 | $22.91 | $44.67 |
Prevea360 Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Quartz Setting Professional Modifier None Typical Low $22.91 Median $43.65 Typical High $66.07 | Professional | None | $22.91 | $43.65 | $66.07 |
Quartz Setting Facility Modifier None Typical Low $28.18 Median $64.57 Typical High $64.57 | Facility | None | $28.18 | $64.57 | $64.57 |
Quartz Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Security Health Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $69.18 | Professional | None | $37.15 | $37.15 | $69.18 |
United Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $28.84 | Professional | None | $20.89 | $20.89 | $28.84 |
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 $29.51 | Professional | 52 · Reduced service | $10.47 | $10.47 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $11.75 | Professional | 53 · Discontinued | $4.17 | $4.17 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $8.91 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $5.89 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $5.89 |
Where Wisconsin sits
The same service costs 1.9 times more in Kansas than in Connecticut. 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· 4th of 51
$28.84
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.