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 $2.19 Median $2.19 Typical High $4.90 | Facility | None | $2.19 | $2.19 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $5.01 | Professional | None | $2.19 | $2.19 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $4.57 | Facility | None | $2.69 | $2.69 | $4.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.34 Typical High $3.24 | Professional | None | $2.14 | $2.34 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $5.01 Typical High $6.61 | Facility | None | $3.09 | $5.01 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.69 Typical High $3.80 | Professional | None | $2.14 | $2.69 | $3.80 |
DeanCare Setting Facility Modifier None Typical Low $1.32 Median $2.04 Typical High $4.27 | Facility | None | $1.32 | $2.04 | $4.27 |
DeanCare Setting Professional Modifier None Typical Low $3.09 Median $4.17 Typical High $4.17 | Professional | None | $3.09 | $4.17 | $4.17 |
Medica Setting Facility Modifier None Typical Low $1.32 Median $2.00 Typical High $4.27 | Facility | None | $1.32 | $2.00 | $4.27 |
Medica Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $3.31 | Professional | None | $2.00 | $2.00 | $3.31 |
Network Health Setting Facility Modifier None Typical Low $1.91 Median $1.95 Typical High $1.95 | Facility | None | $1.91 | $1.95 | $1.95 |
Prevea360 Setting Facility Modifier None Typical Low $1.32 Median $2.04 Typical High $4.27 | Facility | None | $1.32 | $2.04 | $4.27 |
Prevea360 Setting Professional Modifier None Typical Low $3.09 Median $4.17 Typical High $4.17 | Professional | None | $3.09 | $4.17 | $4.17 |
Quartz Setting Professional Modifier None Typical Low $2.14 Median $3.39 Typical High $5.13 | Professional | None | $2.14 | $3.39 | $5.13 |
Quartz Setting Facility Modifier None Typical Low $2.88 Median $6.61 Typical High $6.61 | Facility | None | $2.88 | $6.61 | $6.61 |
Quartz Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Security Health Setting Professional Modifier None Typical Low $1.45 Median $2.88 Typical High $3.55 | Professional | None | $1.45 | $2.88 | $3.55 |
United Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Facility | None | $2.14 | $2.14 | $2.14 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.95 | Professional | None | $2.14 | $2.14 | $2.95 |
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 $1.12 Median $1.12 Typical High $2.51 | Professional | 52 · Reduced service | $1.12 | $1.12 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $1.00 | Professional | 53 · Discontinued | $0.44 | $0.44 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.76 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.50 |
Where Wisconsin sits
The same service costs 1.6 times more in Arizona than in Mississippi. 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· 7th of 51
$2.45
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.