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 $8.32 Median $8.32 Typical High $10.23 | Facility | None | $8.32 | $8.32 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $12.02 | Professional | None | $8.32 | $8.32 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.91 Typical High $12.02 | Professional | None | $8.13 | $8.91 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $10.72 Typical High $24.55 | Facility | None | $5.89 | $10.72 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $5.62 Typical High $8.13 | Professional | None | $3.24 | $5.62 | $8.13 |
DeanCare Setting Facility Modifier None Typical Low $2.19 Median $2.19 Typical High $5.01 | Facility | None | $2.19 | $2.19 | $5.01 |
DeanCare Setting Professional Modifier None Typical Low $1.86 Median $4.37 Typical High $4.37 | Professional | None | $1.86 | $4.37 | $4.37 |
Medica Setting Facility Modifier None Typical Low $4.57 Median $34.67 Typical High $67.61 | Facility | None | $4.57 | $34.67 | $67.61 |
Medica Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $6.31 | Professional | None | $4.57 | $4.57 | $6.31 |
Network Health Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $7.59 | Facility | None | $4.90 | $4.90 | $7.59 |
Prevea360 Setting Facility Modifier None Typical Low $2.19 Median $2.19 Typical High $5.01 | Facility | None | $2.19 | $2.19 | $5.01 |
Prevea360 Setting Professional Modifier None Typical Low $1.86 Median $4.37 Typical High $4.37 | Professional | None | $1.86 | $4.37 | $4.37 |
Quartz Setting Professional Modifier None Typical Low $3.09 Median $7.08 Typical High $8.13 | Professional | None | $3.09 | $7.08 | $8.13 |
Quartz Setting Facility Modifier None Typical Low $10.72 Median $24.55 Typical High $24.55 | Facility | None | $10.72 | $24.55 | $24.55 |
Quartz Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Security Health Setting Professional Modifier None Typical Low $2.95 Median $10.96 Typical High $13.49 | Professional | None | $2.95 | $10.96 | $13.49 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $6.03 | Professional | None | $4.47 | $4.47 | $6.03 |
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 $4.17 Median $4.17 Typical High $6.03 | Professional | 52 · Reduced service | $4.17 | $4.17 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.66 Typical High $2.40 | Professional | 53 · Discontinued | $1.66 | $1.66 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.26 Typical High $1.82 | Professional | 55 · Aftercare only | $1.26 | $1.26 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.83 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.83 | $0.83 | $1.20 |
Where Wisconsin sits
The same service costs 10.7 times more in Minnesota 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· 19th of 51
$8.13
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.