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 $0.66 Median $0.66 Typical High $1.55 | Facility | None | $0.66 | $0.66 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $0.66 Median $0.66 Typical High $7.94 | Professional | None | $0.66 | $0.66 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Facility | None | $0.79 | $0.79 | $0.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.65 Median $0.71 Typical High $0.95 | Professional | None | $0.65 | $0.71 | $0.95 |
Cigna Setting Facility Modifier None Typical Low $1.00 Median $1.91 Typical High $2.14 | Facility | None | $1.00 | $1.91 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $1.00 Typical High $1.45 | Professional | None | $0.65 | $1.00 | $1.45 |
DeanCare Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $1.41 | Facility | None | $0.79 | $0.79 | $1.41 |
DeanCare Setting Professional Modifier None Typical Low $0.54 Median $1.58 Typical High $1.58 | Professional | None | $0.54 | $1.58 | $1.58 |
Medica Setting Facility Modifier None Typical Low $0.87 Median $0.87 Typical High $5.13 | Facility | None | $0.87 | $0.87 | $5.13 |
Medica Setting Professional Modifier None Typical Low $0.87 Median $0.87 Typical High $1.32 | Professional | None | $0.87 | $0.87 | $1.32 |
Network Health Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $1.26 | Facility | None | $0.81 | $0.81 | $1.26 |
Prevea360 Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $1.41 | Facility | None | $0.79 | $0.79 | $1.41 |
Prevea360 Setting Professional Modifier None Typical Low $0.54 Median $1.58 Typical High $1.58 | Professional | None | $0.54 | $1.58 | $1.58 |
Quartz Setting Professional Modifier None Typical Low $0.65 Median $1.10 Typical High $2.04 | Professional | None | $0.65 | $1.10 | $2.04 |
Quartz Setting Facility Modifier None Typical Low $0.85 Median $1.95 Typical High $1.95 | Facility | None | $0.85 | $1.95 | $1.95 |
Quartz Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Security Health Setting Professional Modifier None Typical Low $0.85 Median $0.87 Typical High $1.62 | Professional | None | $0.85 | $0.87 | $1.62 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.93 | Professional | None | $0.68 | $0.68 | $0.93 |
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 $0.33 Median $0.33 Typical High $3.98 | Professional | 52 · Reduced service | $0.33 | $0.33 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $1.58 | Professional | 53 · Discontinued | $0.13 | $0.13 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $1.20 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.79 |
Where Wisconsin sits
The same service costs 2.6 times more in Texas than in Wyoming. 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
$0.79
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.