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 $18.62 Median $18.62 Typical High $40.74 | Facility | None | $18.62 | $18.62 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $44.67 | Professional | None | $18.62 | $18.62 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $38.02 | Facility | None | $22.39 | $22.39 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $19.50 Typical High $26.92 | Professional | None | $17.78 | $19.50 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $27.54 Typical High $54.95 | Facility | None | $18.62 | $27.54 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $22.91 Typical High $33.11 | Professional | None | $17.78 | $22.91 | $33.11 |
DeanCare Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $39.81 | Facility | None | $18.20 | $18.20 | $39.81 |
DeanCare Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $36.31 | Professional | None | $26.92 | $36.31 | $36.31 |
Medica Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $40.74 | Facility | None | $18.20 | $18.20 | $40.74 |
Medica Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $27.54 | Professional | None | $18.20 | $18.20 | $27.54 |
Network Health Setting Facility Modifier None Typical Low $19.05 Median $19.50 Typical High $19.50 | Facility | None | $19.05 | $19.50 | $19.50 |
Prevea360 Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $39.81 | Facility | None | $18.20 | $18.20 | $39.81 |
Prevea360 Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $36.31 | Professional | None | $26.92 | $36.31 | $36.31 |
Quartz Setting Professional Modifier None Typical Low $17.78 Median $28.18 Typical High $47.86 | Professional | None | $17.78 | $28.18 | $47.86 |
Quartz Setting Facility Modifier None Typical Low $23.99 Median $54.95 Typical High $54.95 | Facility | None | $23.99 | $54.95 | $54.95 |
Quartz Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Security Health Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $29.51 | Professional | None | $23.99 | $23.99 | $29.51 |
United Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $23.99 | Professional | None | $17.38 | $17.38 | $23.99 |
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 $9.33 Median $9.33 Typical High $22.39 | Professional | 52 · Reduced service | $9.33 | $9.33 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $8.91 | Professional | 53 · Discontinued | $3.72 | $3.72 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $6.76 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $4.47 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $4.47 |
Where Wisconsin sits
The same service costs 1.5 times more in Alaska than in Rhode Island. 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· 13th of 51
$20.42
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.