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 $1.26 Median $1.26 Typical High $2.51 | Facility | None | $1.26 | $1.26 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.23 Median $1.35 Typical High $1.82 | Professional | None | $1.23 | $1.35 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $1.62 Median $2.69 Typical High $3.72 | Facility | None | $1.62 | $2.69 | $3.72 |
Cigna Setting Professional Modifier None Typical Low $1.23 Median $1.55 Typical High $2.00 | Professional | None | $1.23 | $1.55 | $2.00 |
DeanCare Setting Facility Modifier None Typical Low $1.07 Median $1.07 Typical High $2.14 | Facility | None | $1.07 | $1.07 | $2.14 |
DeanCare Setting Professional Modifier None Typical Low $1.62 Median $2.14 Typical High $3.47 | Professional | None | $1.62 | $2.14 | $3.47 |
Medica Setting Facility Modifier None Typical Low $1.12 Median $4.79 Typical High $11.48 | Facility | None | $1.12 | $4.79 | $11.48 |
Medica Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $2.14 | Professional | None | $1.12 | $1.12 | $2.14 |
Network Health Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
Prevea360 Setting Facility Modifier None Typical Low $1.07 Median $1.07 Typical High $2.14 | Facility | None | $1.07 | $1.07 | $2.14 |
Prevea360 Setting Professional Modifier None Typical Low $1.62 Median $2.14 Typical High $3.47 | Professional | None | $1.62 | $2.14 | $3.47 |
Quartz Setting Professional Modifier None Typical Low $1.23 Median $1.74 Typical High $5.01 | Professional | None | $1.23 | $1.74 | $5.01 |
Quartz Setting Facility Modifier None Typical Low $1.62 Median $3.72 Typical High $3.72 | Facility | None | $1.62 | $3.72 | $3.72 |
Quartz Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
Security Health Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $2.40 | Professional | None | $1.66 | $1.66 | $2.40 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.48 | Professional | None | $1.10 | $1.10 | $1.48 |
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 $0.63 Median $0.63 Typical High $8.91 | Professional | 52 · Reduced service | $0.63 | $0.63 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.25 Typical High $6.03 | Professional | 53 · Discontinued | $0.25 | $0.25 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $4.47 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $3.02 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $3.02 |
Where Wisconsin sits
The same service costs 3.8 times more in Texas 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· 13th of 51
$1.41
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.