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 $19.50 Median $19.50 Typical High $28.18 | Facility | None | $19.50 | $19.50 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $33.88 | Professional | None | $19.50 | $19.50 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $20.89 Typical High $28.18 | Professional | None | $19.05 | $20.89 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $33.11 Typical High $57.54 | Facility | None | $25.12 | $33.11 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $19.50 Typical High $25.12 | Professional | None | $18.20 | $19.50 | $25.12 |
DeanCare Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $26.30 | Facility | None | $12.02 | $12.02 | $26.30 |
DeanCare Setting Professional Modifier None Typical Low $18.20 Median $23.99 Typical High $23.99 | Professional | None | $18.20 | $23.99 | $23.99 |
Medica Setting Facility Modifier None Typical Low $10.72 Median $15.14 Typical High $67.61 | Facility | None | $10.72 | $15.14 | $67.61 |
Medica Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $19.95 | Professional | None | $10.72 | $10.72 | $19.95 |
Network Health Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Prevea360 Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $26.30 | Facility | None | $12.02 | $12.02 | $26.30 |
Prevea360 Setting Professional Modifier None Typical Low $18.20 Median $23.99 Typical High $23.99 | Professional | None | $18.20 | $23.99 | $23.99 |
Quartz Setting Professional Modifier None Typical Low $15.85 Median $19.50 Typical High $35.48 | Professional | None | $15.85 | $19.50 | $35.48 |
Quartz Setting Facility Modifier None Typical Low $25.12 Median $57.54 Typical High $57.54 | Facility | None | $25.12 | $57.54 | $57.54 |
Quartz Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Security Health Setting Professional Modifier None Typical Low $17.38 Median $25.70 Typical High $31.62 | Professional | None | $17.38 | $25.70 | $31.62 |
United Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
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 $9.77 Median $9.77 Typical High $16.98 | Professional | 52 · Reduced service | $9.77 | $9.77 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $6.76 | Professional | 53 · Discontinued | $3.89 | $3.89 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $5.13 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $3.39 |
Where Wisconsin sits
The same service costs 2.7 times more in Wyoming than in Maryland. 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· 7th of 51
$19.50
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.