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 $4.68 Median $4.68 Typical High $9.55 | Facility | None | $4.68 | $4.68 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.68 Typical High $4.68 | Professional | None | $4.47 | $4.68 | $4.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.47 Median $5.01 Typical High $6.76 | Professional | None | $4.47 | $5.01 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $6.76 Median $10.96 Typical High $13.80 | Facility | None | $6.76 | $10.96 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $6.17 Typical High $8.32 | Professional | None | $4.47 | $6.17 | $8.32 |
DeanCare Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $17.38 | Facility | None | $4.79 | $4.79 | $17.38 |
DeanCare Setting Professional Modifier None Typical Low $7.24 Median $9.55 Typical High $9.55 | Professional | None | $7.24 | $9.55 | $9.55 |
Medica Setting Facility Modifier None Typical Low $4.79 Median $10.72 Typical High $45.71 | Facility | None | $4.79 | $10.72 | $45.71 |
Medica Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $9.55 | Professional | None | $4.79 | $4.79 | $9.55 |
Network Health Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Prevea360 Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $17.38 | Facility | None | $4.79 | $4.79 | $17.38 |
Prevea360 Setting Professional Modifier None Typical Low $7.24 Median $9.55 Typical High $9.55 | Professional | None | $7.24 | $9.55 | $9.55 |
Quartz Setting Professional Modifier None Typical Low $4.47 Median $6.76 Typical High $12.30 | Professional | None | $4.47 | $6.76 | $12.30 |
Quartz Setting Facility Modifier None Typical Low $6.03 Median $13.80 Typical High $13.80 | Facility | None | $6.03 | $13.80 | $13.80 |
Quartz Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Security Health Setting Professional Modifier None Typical Low $6.03 Median $6.17 Typical High $20.42 | Professional | None | $6.03 | $6.17 | $20.42 |
United Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $5.75 | Professional | None | $4.17 | $4.17 | $5.75 |
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 $2.29 Median $2.29 Typical High $39.81 | Professional | 52 · Reduced service | $2.29 | $2.29 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $0.93 Typical High $15.85 | Professional | 53 · Discontinued | $0.93 | $0.93 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.71 Typical High $12.02 | Professional | 55 · Aftercare only | $0.71 | $0.71 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.46 Typical High $7.94 | Professional | 56 · Pre-op care only | $0.46 | $0.46 | $7.94 |
Where Wisconsin sits
The same service costs 5.9 times more in Texas than in Rhode Island. 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· 16th of 51
$5.13
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.