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 $12.30 Median $12.30 Typical High $28.84 | Facility | None | $12.30 | $12.30 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $13.18 Typical High $18.20 | Professional | None | $12.02 | $13.18 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $27.54 Typical High $36.31 | Facility | None | $18.62 | $27.54 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $15.49 Typical High $20.89 | Professional | None | $12.02 | $15.49 | $20.89 |
DeanCare Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $21.38 | Facility | None | $9.55 | $9.55 | $21.38 |
DeanCare Setting Professional Modifier None Typical Low $14.45 Median $19.50 Typical High $20.89 | Professional | None | $14.45 | $19.50 | $20.89 |
Medica Setting Facility Modifier None Typical Low $10.96 Median $11.22 Typical High $25.12 | Facility | None | $10.96 | $11.22 | $25.12 |
Medica Setting Professional Modifier None Typical Low $11.22 Median $14.45 Typical High $66.07 | Professional | None | $11.22 | $14.45 | $66.07 |
Network Health Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $20.42 | Facility | None | $9.33 | $9.33 | $20.42 |
Prevea360 Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $21.38 | Facility | None | $9.55 | $9.55 | $21.38 |
Prevea360 Setting Professional Modifier None Typical Low $14.45 Median $19.50 Typical High $20.89 | Professional | None | $14.45 | $19.50 | $20.89 |
Quartz Setting Professional Modifier None Typical Low $12.02 Median $17.78 Typical High $25.12 | Professional | None | $12.02 | $17.78 | $25.12 |
Quartz Setting Facility Modifier None Typical Low $19.95 Median $36.31 Typical High $36.31 | Facility | None | $19.95 | $36.31 | $36.31 |
Quartz Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Security Health Setting Professional Modifier None Typical Low $12.59 Median $16.22 Typical High $19.95 | Professional | None | $12.59 | $16.22 | $19.95 |
United Setting Professional Modifier None Typical Low $12.30 Median $13.80 Typical High $67.61 | Professional | None | $12.30 | $13.80 | $67.61 |
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 $6.17 Median $6.17 Typical High $70.79 | Professional | 52 · Reduced service | $6.17 | $6.17 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $28.84 | Professional | 53 · Discontinued | $2.45 | $2.45 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $21.38 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $14.45 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $14.45 |
Where Wisconsin sits
The same service costs 1.9 times more in Alaska than in Pennsylvania. 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· 12th of 51
$14.13
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.