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 $446.68 Median $446.68 Typical High $1,000.00 | Facility | None | $446.68 | $446.68 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $794.33 | Professional | None | $446.68 | $446.68 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $1,174.90 | Professional | None | $467.74 | $776.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,445.44 | Facility | None | $741.31 | $1,202.26 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $794.33 | Professional | None | $478.63 | $630.96 | $794.33 |
DeanCare Setting Facility Modifier None Typical Low $251.19 Median $489.78 Typical High $489.78 | Facility | None | $251.19 | $489.78 | $489.78 |
DeanCare Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $741.31 | Professional | None | $89.13 | $89.13 | $741.31 |
Medica Setting Facility Modifier None Typical Low $4.27 Median $446.68 Typical High $489.78 | Facility | None | $4.27 | $446.68 | $489.78 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
Network Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Prevea360 Setting Facility Modifier None Typical Low $251.19 Median $489.78 Typical High $489.78 | Facility | None | $251.19 | $489.78 | $489.78 |
Prevea360 Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $741.31 | Professional | None | $89.13 | $89.13 | $741.31 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $269.15 Typical High $758.58 | Professional | None | $131.83 | $269.15 | $758.58 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $1,445.44 Typical High $1,445.44 | Facility | None | $630.96 | $1,445.44 | $1,445.44 |
Quartz Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Security Health Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $812.83 | Professional | None | $446.68 | $660.69 | $812.83 |
United Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
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 $223.87 Median $223.87 Typical High $398.11 | Professional | 52 · Reduced service | $223.87 | $223.87 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $158.49 | Professional | 53 · Discontinued | $89.13 | $89.13 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $120.23 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $79.43 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $79.43 |
Where Wisconsin sits
The same service costs 2.3 times more in Arizona than in Idaho. 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· 5th of 51
$575
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.