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 $83.18 Median $83.18 Typical High $186.21 | Facility | None | $83.18 | $83.18 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $251.19 | Professional | None | $83.18 | $83.18 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $281.84 | Professional | None | $81.28 | $87.10 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $229.09 Typical High $269.15 | Facility | None | $138.04 | $229.09 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $158.49 | Professional | None | $89.13 | $117.49 | $158.49 |
DeanCare Setting Facility Modifier None Typical Low $81.28 Median $91.20 Typical High $173.78 | Facility | None | $81.28 | $91.20 | $173.78 |
DeanCare Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $138.04 | Professional | None | $63.10 | $63.10 | $138.04 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $91.20 Typical High $173.78 | Facility | None | $81.28 | $91.20 | $173.78 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $117.49 | Professional | None | $87.10 | $87.10 | $117.49 |
Network Health Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $186.21 | Facility | None | $109.65 | $109.65 | $186.21 |
Prevea360 Setting Facility Modifier None Typical Low $81.28 Median $91.20 Typical High $173.78 | Facility | None | $81.28 | $91.20 | $173.78 |
Prevea360 Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $138.04 | Professional | None | $63.10 | $63.10 | $138.04 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $245.47 | Professional | None | $107.15 | $169.82 | $245.47 |
Quartz Setting Facility Modifier None Typical Low $117.49 Median $269.15 Typical High $269.15 | Facility | None | $117.49 | $269.15 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Security Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $275.42 | Professional | None | $147.91 | $147.91 | $275.42 |
United Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $117.49 | Professional | None | $87.10 | $87.10 | $117.49 |
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 $41.69 Median $41.69 Typical High $125.89 | Professional | 52 · Reduced service | $41.69 | $41.69 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $50.12 | Professional | 53 · Discontinued | $16.60 | $16.60 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $38.02 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $25.12 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $25.12 |
Where Wisconsin sits
The same service costs 1.6 times more in Alaska than in Texas. 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· 8th of 51
$97.72
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.