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 $1.45 Median $1.45 Typical High $2.69 | Facility | None | $1.45 | $1.45 | $2.69 |
Aetna Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $2.00 | Professional | None | $1.45 | $1.45 | $2.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.38 Median $1.51 Typical High $2.09 | Professional | None | $1.38 | $1.51 | $2.09 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $2.88 Typical High $4.17 | Facility | None | $1.82 | $2.88 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $1.38 Median $1.51 Typical High $2.19 | Professional | None | $1.38 | $1.51 | $2.19 |
DeanCare Setting Facility Modifier None Typical Low $0.66 Median $1.10 Typical High $2.14 | Facility | None | $0.66 | $1.10 | $2.14 |
DeanCare Setting Professional Modifier None Typical Low $0.26 Median $2.19 Typical High $2.19 | Professional | None | $0.26 | $2.19 | $2.19 |
Medica Setting Facility Modifier None Typical Low $0.95 Median $5.25 Typical High $7.94 | Facility | None | $0.95 | $5.25 | $7.94 |
Medica Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $2.19 | Professional | None | $0.95 | $0.95 | $2.19 |
Network Health Setting Facility Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Facility | None | $1.02 | $1.02 | $1.02 |
Prevea360 Setting Facility Modifier None Typical Low $0.66 Median $1.10 Typical High $2.14 | Facility | None | $0.66 | $1.10 | $2.14 |
Prevea360 Setting Professional Modifier None Typical Low $0.26 Median $2.19 Typical High $2.19 | Professional | None | $0.26 | $2.19 | $2.19 |
Quartz Setting Professional Modifier None Typical Low $1.12 Median $1.62 Typical High $2.63 | Professional | None | $1.12 | $1.62 | $2.63 |
Quartz Setting Facility Modifier None Typical Low $1.82 Median $4.17 Typical High $4.17 | Facility | None | $1.82 | $4.17 | $4.17 |
Quartz Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Security Health Setting Professional Modifier None Typical Low $0.87 Median $1.86 Typical High $2.29 | Professional | None | $0.87 | $1.86 | $2.29 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $1.58 | Professional | None | $1.15 | $1.15 | $1.58 |
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 $0.72 Median $0.72 Typical High $1.00 | Professional | 52 · Reduced service | $0.72 | $0.72 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.40 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.30 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.20 |
Where Wisconsin sits
The same service costs 5.9 times more in Vermont than in Oklahoma. 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· 15th of 51
$1.51
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.