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 $2.24 Median $2.24 Typical High $5.50 | Facility | None | $2.24 | $2.24 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $10.00 | Professional | None | $2.24 | $2.24 | $10.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Facility | None | $2.75 | $2.75 | $2.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.19 Median $2.40 Typical High $3.31 | Professional | None | $2.19 | $2.40 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $3.31 Median $5.37 Typical High $6.76 | Facility | None | $3.31 | $5.37 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.82 Typical High $4.07 | Professional | None | $2.19 | $2.82 | $4.07 |
DeanCare Setting Facility Modifier None Typical Low $1.66 Median $2.04 Typical High $4.27 | Facility | None | $1.66 | $2.04 | $4.27 |
DeanCare Setting Professional Modifier None Typical Low $3.02 Median $4.07 Typical High $4.07 | Professional | None | $3.02 | $4.07 | $4.07 |
Medica Setting Facility Modifier None Typical Low $1.66 Median $2.19 Typical High $5.01 | Facility | None | $1.66 | $2.19 | $5.01 |
Medica Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $4.07 | Professional | None | $2.19 | $2.19 | $4.07 |
Network Health Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $6.46 | Facility | None | $2.51 | $2.51 | $6.46 |
Prevea360 Setting Facility Modifier None Typical Low $1.66 Median $2.04 Typical High $4.27 | Facility | None | $1.66 | $2.04 | $4.27 |
Prevea360 Setting Professional Modifier None Typical Low $3.02 Median $4.07 Typical High $4.07 | Professional | None | $3.02 | $4.07 | $4.07 |
Quartz Setting Professional Modifier None Typical Low $2.19 Median $3.80 Typical High $5.25 | Professional | None | $2.19 | $3.80 | $5.25 |
Quartz Setting Facility Modifier None Typical Low $2.95 Median $6.76 Typical High $6.76 | Facility | None | $2.95 | $6.76 | $6.76 |
Quartz Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Security Health Setting Professional Modifier None Typical Low $2.04 Median $2.95 Typical High $3.63 | Professional | None | $2.04 | $2.95 | $3.63 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $3.24 | Professional | None | $2.40 | $2.40 | $3.24 |
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 $0.34 Median $0.34 Typical High $3.72 | Professional | 55 · Aftercare only | $0.34 | $0.34 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $2.51 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $2.51 |
Where Wisconsin sits
The same service costs 1.9 times more in Wyoming than in South Carolina. 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
$2.51
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.