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 $0.15 Median $0.15 Typical High $0.38 | Facility | None | $0.15 | $0.15 | $0.38 |
Aetna Setting Professional Modifier None Typical Low $0.14 Median $0.15 Typical High $7.08 | Professional | None | $0.14 | $0.15 | $7.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.18 Median $0.18 Typical High $0.18 | Facility | None | $0.18 | $0.18 | $0.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.14 Median $0.15 Typical High $0.21 | Professional | None | $0.14 | $0.15 | $0.21 |
Cigna Setting Facility Modifier None Typical Low $0.22 Median $0.36 Typical High $0.43 | Facility | None | $0.22 | $0.36 | $0.43 |
Cigna Setting Professional Modifier None Typical Low $0.14 Median $0.20 Typical High $0.26 | Professional | None | $0.14 | $0.20 | $0.26 |
DeanCare Setting Facility Modifier None Typical Low $0.15 Median $0.15 Typical High $0.71 | Facility | None | $0.15 | $0.15 | $0.71 |
DeanCare Setting Professional Modifier None Typical Low $0.23 Median $0.30 Typical High $0.30 | Professional | None | $0.23 | $0.30 | $0.30 |
Medica Setting Facility Modifier None Typical Low $0.16 Median $1.70 Typical High $8.51 | Facility | None | $0.16 | $1.70 | $8.51 |
Medica Setting Professional Modifier None Typical Low $0.16 Median $0.16 Typical High $0.30 | Professional | None | $0.16 | $0.16 | $0.30 |
Network Health Setting Facility Modifier None Typical Low $0.15 Median $0.15 Typical High $0.37 | Facility | None | $0.15 | $0.15 | $0.37 |
Prevea360 Setting Facility Modifier None Typical Low $0.15 Median $0.15 Typical High $0.71 | Facility | None | $0.15 | $0.15 | $0.71 |
Prevea360 Setting Professional Modifier None Typical Low $0.23 Median $0.30 Typical High $0.30 | Professional | None | $0.23 | $0.30 | $0.30 |
Quartz Setting Professional Modifier None Typical Low $0.14 Median $0.26 Typical High $0.87 | Professional | None | $0.14 | $0.26 | $0.87 |
Quartz Setting Facility Modifier None Typical Low $0.19 Median $0.43 Typical High $0.43 | Facility | None | $0.19 | $0.43 | $0.43 |
Quartz Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | None | $0.14 | $0.14 | $0.14 |
Security Health Setting Professional Modifier None Typical Low $0.14 Median $0.19 Typical High $0.23 | Professional | None | $0.14 | $0.19 | $0.23 |
United Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.23 | Professional | None | $0.17 | $0.17 | $0.23 |
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 $0.08 Median $0.08 Typical High $4.47 | Professional | 52 · Reduced service | $0.08 | $0.08 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $1.82 | Professional | 53 · Discontinued | $0.03 | $0.03 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $1.35 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.89 |
Where Wisconsin sits
The same service costs 4.4 times more in Michigan 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· 31st of 51
$0.17
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.