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 $26.30 Median $26.30 Typical High $63.10 | Facility | None | $26.30 | $26.30 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $83.18 | Professional | None | $26.30 | $26.30 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $38.02 | Professional | None | $25.70 | $28.18 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $56.23 Typical High $77.62 | Facility | None | $33.88 | $56.23 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $32.36 Typical High $42.66 | Professional | None | $25.70 | $32.36 | $42.66 |
DeanCare Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $54.95 | Facility | None | $25.70 | $25.70 | $54.95 |
DeanCare Setting Professional Modifier None Typical Low $19.05 Median $51.29 Typical High $51.29 | Professional | None | $19.05 | $51.29 | $51.29 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $27.54 Typical High $54.95 | Facility | None | $26.30 | $27.54 | $54.95 |
Medica Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $51.29 | Professional | None | $27.54 | $27.54 | $51.29 |
Network Health Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Prevea360 Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $54.95 | Facility | None | $25.70 | $25.70 | $54.95 |
Prevea360 Setting Professional Modifier None Typical Low $19.05 Median $51.29 Typical High $51.29 | Professional | None | $19.05 | $51.29 | $51.29 |
Quartz Setting Professional Modifier None Typical Low $25.70 Median $43.65 Typical High $66.07 | Professional | None | $25.70 | $43.65 | $66.07 |
Quartz Setting Facility Modifier None Typical Low $33.88 Median $77.62 Typical High $77.62 | Facility | None | $33.88 | $77.62 | $77.62 |
Quartz Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Security Health Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $42.66 | Professional | None | $30.20 | $34.67 | $42.66 |
United Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | None | $27.54 | $27.54 | $38.02 |
2 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 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $12.59 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $8.32 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $8.32 |
Where Wisconsin sits
The same service costs 1.9 times more in Alaska than in New Jersey. 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· 9th of 51
$30.90
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.