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 $3.02 Median $3.02 Typical High $7.41 | Facility | None | $3.02 | $3.02 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $30.20 | Professional | None | $3.02 | $3.02 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $3.39 Typical High $4.47 | Professional | None | $2.95 | $3.39 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $4.57 Median $8.51 Typical High $9.55 | Facility | None | $4.57 | $8.51 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $4.68 Typical High $6.31 | Professional | None | $2.95 | $4.68 | $6.31 |
DeanCare Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $8.32 | Facility | None | $3.47 | $3.47 | $8.32 |
DeanCare Setting Professional Modifier None Typical Low $5.25 Median $6.92 Typical High $6.92 | Professional | None | $5.25 | $6.92 | $6.92 |
Medica Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $12.88 | Facility | None | $3.47 | $3.47 | $12.88 |
Medica Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $5.37 | Professional | None | $3.47 | $3.47 | $5.37 |
Network Health Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $16.60 | Facility | None | $4.57 | $4.57 | $16.60 |
Prevea360 Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $8.32 | Facility | None | $3.47 | $3.47 | $8.32 |
Prevea360 Setting Professional Modifier None Typical Low $5.25 Median $6.92 Typical High $6.92 | Professional | None | $5.25 | $6.92 | $6.92 |
Quartz Setting Professional Modifier None Typical Low $2.95 Median $5.13 Typical High $15.85 | Professional | None | $2.95 | $5.13 | $15.85 |
Quartz Setting Facility Modifier None Typical Low $3.89 Median $8.91 Typical High $8.91 | Facility | None | $3.89 | $8.91 | $8.91 |
Quartz Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Security Health Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $15.14 | Professional | None | $3.98 | $3.98 | $15.14 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $4.37 | Professional | None | $3.16 | $3.16 | $4.37 |
2 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 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $4.47 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $3.02 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $3.02 |
Where Wisconsin sits
The same service costs 6.0 times more in Oklahoma than in Wyoming. 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· 11th of 51
$3.55
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.