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 $97.72 Median $97.72 Typical High $218.78 | Facility | None | $97.72 | $97.72 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $234.42 | Professional | None | $97.72 | $97.72 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $61.66 Typical High $158.49 | Professional | None | $26.92 | $61.66 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $331.13 | Facility | None | $162.18 | $263.03 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $107.15 Typical High $128.82 | Professional | None | $46.77 | $107.15 | $128.82 |
DeanCare Setting Facility Modifier None Typical Low $58.88 Median $107.15 Typical High $107.15 | Facility | None | $58.88 | $107.15 | $107.15 |
DeanCare Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $162.18 | Professional | None | $3.98 | $3.98 | $162.18 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $107.15 Typical High $107.15 | Facility | None | $58.88 | $107.15 | $107.15 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Network Health Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Prevea360 Setting Facility Modifier None Typical Low $58.88 Median $107.15 Typical High $107.15 | Facility | None | $58.88 | $107.15 | $107.15 |
Prevea360 Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $162.18 | Professional | None | $3.98 | $3.98 | $162.18 |
Quartz Setting Professional Modifier None Typical Low $30.20 Median $63.10 Typical High $95.50 | Professional | None | $30.20 | $63.10 | $95.50 |
Quartz Setting Facility Modifier None Typical Low $144.54 Median $331.13 Typical High $331.13 | Facility | None | $144.54 | $331.13 | $331.13 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Security Health Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $181.97 | Professional | None | $114.82 | $147.91 | $181.97 |
United Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
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 $48.98 Median $48.98 Typical High $117.49 | Professional | 52 · Reduced service | $48.98 | $48.98 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $46.77 | Professional | 53 · Discontinued | $19.50 | $19.50 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $35.48 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $23.44 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $23.44 |
Where Wisconsin sits
The same service costs 3.9 times more in Alaska than in Montana. 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· 43rd of 51
$107
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.