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 $154.88 Median $154.88 Typical High $338.84 | Facility | None | $154.88 | $154.88 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $117.49 Typical High $162.18 | Professional | None | $44.67 | $117.49 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $218.78 Typical High $501.19 | Facility | None | $102.33 | $218.78 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $162.18 | Professional | None | $61.66 | $87.10 | $162.18 |
DeanCare Setting Facility Modifier None Typical Low $44.67 Median $58.88 Typical High $186.21 | Facility | None | $44.67 | $58.88 | $186.21 |
DeanCare Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $50.12 Typical High $186.21 | Facility | None | $44.67 | $50.12 | $186.21 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | None | $154.88 | $154.88 | $213.80 |
Network Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $177.83 | Facility | None | $173.78 | $173.78 | $177.83 |
Prevea360 Setting Facility Modifier None Typical Low $44.67 Median $58.88 Typical High $186.21 | Facility | None | $44.67 | $58.88 | $186.21 |
Prevea360 Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Quartz Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $134.90 | Professional | None | $58.88 | $93.33 | $134.90 |
Quartz Setting Facility Modifier None Typical Low $218.78 Median $501.19 Typical High $501.19 | Facility | None | $218.78 | $501.19 | $501.19 |
Quartz Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Security Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $151.36 | Professional | None | $81.28 | $81.28 | $151.36 |
United Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
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 $77.62 Median $77.62 Typical High $1,122.02 | Professional | 52 · Reduced service | $77.62 | $77.62 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $446.68 | Professional | 53 · Discontinued | $30.90 | $30.90 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $331.13 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $223.87 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $223.87 |
Where Wisconsin sits
The same service costs 4.4 times more in Alaska than in Hawaii. 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· 40th of 51
$155
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.