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 $60.26 Median $60.26 Typical High $104.71 | Facility | None | $60.26 | $60.26 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $204.17 | Professional | None | $60.26 | $60.26 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $181.97 | Professional | None | $50.12 | $53.70 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $128.82 Typical High $154.88 | Facility | None | $79.43 | $128.82 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $102.33 | Professional | None | $51.29 | $66.07 | $102.33 |
DeanCare Setting Facility Modifier None Typical Low $35.48 Median $52.48 Typical High $114.82 | Facility | None | $35.48 | $52.48 | $114.82 |
DeanCare Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Medica Setting Facility Modifier None Typical Low $35.48 Median $44.67 Typical High $87.10 | Facility | None | $35.48 | $44.67 | $87.10 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | None | $37.15 | $37.15 | $51.29 |
Network Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Prevea360 Setting Facility Modifier None Typical Low $35.48 Median $52.48 Typical High $114.82 | Facility | None | $35.48 | $52.48 | $114.82 |
Prevea360 Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Quartz Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $158.49 | Professional | None | $70.79 | $112.20 | $158.49 |
Quartz Setting Facility Modifier None Typical Low $67.61 Median $154.88 Typical High $154.88 | Facility | None | $67.61 | $154.88 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Security Health Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $181.97 | Professional | None | $97.72 | $123.03 | $181.97 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
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 $30.20 Median $30.20 Typical High $100.00 | Professional | 52 · Reduced service | $30.20 | $30.20 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $40.74 | Professional | 53 · Discontinued | $12.02 | $12.02 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $30.20 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $20.42 |
Where Wisconsin sits
The same service costs 3.0 times more in Kansas 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· 17th of 51
$63.10
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.