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 $36.31 Median $36.31 Typical High $79.43 | Facility | None | $36.31 | $36.31 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $81.28 | Professional | None | $36.31 | $36.31 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $7.08 Typical High $37.15 | Professional | None | $2.63 | $7.08 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $6.17 Typical High $117.49 | Facility | None | $2.88 | $6.17 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $5.13 Typical High $38.02 | Professional | None | $1.86 | $5.13 | $38.02 |
DeanCare Setting Facility Modifier None Typical Low $2.63 Median $5.75 Typical High $44.67 | Facility | None | $2.63 | $5.75 | $44.67 |
DeanCare Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Medica Setting Facility Modifier None Typical Low $2.63 Median $5.75 Typical High $44.67 | Facility | None | $2.63 | $5.75 | $44.67 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | None | $37.15 | $37.15 | $51.29 |
Network Health Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Prevea360 Setting Facility Modifier None Typical Low $2.63 Median $5.75 Typical High $44.67 | Facility | None | $2.63 | $5.75 | $44.67 |
Prevea360 Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Quartz Setting Professional Modifier None Typical Low $3.55 Median $5.62 Typical High $7.94 | Professional | None | $3.55 | $5.62 | $7.94 |
Quartz Setting Facility Modifier None Typical Low $51.29 Median $117.49 Typical High $117.49 | Facility | None | $51.29 | $117.49 | $117.49 |
Quartz Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Security Health Setting Professional Modifier None Typical Low $4.79 Median $6.17 Typical High $8.91 | Professional | None | $4.79 | $6.17 | $8.91 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | None | $37.15 | $37.15 | $51.29 |
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 $18.20 Median $18.20 Typical High $40.74 | Professional | 52 · Reduced service | $18.20 | $18.20 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $16.22 | Professional | 53 · Discontinued | $7.24 | $7.24 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $12.30 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $8.13 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $8.13 |
Where Wisconsin sits
The same service costs 20.4 times more in Arizona than in Hawaii. 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
$37.15
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.