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 $1.62 Median $1.62 Typical High $3.55 | Facility | None | $1.62 | $1.62 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.70 | Professional | None | $1.62 | $1.62 | $1.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Facility | None | $2.00 | $2.00 | $2.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.58 Median $1.78 Typical High $2.40 | Professional | None | $1.58 | $1.78 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $2.45 Median $4.47 Typical High $5.01 | Facility | None | $2.45 | $4.47 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $2.45 Typical High $3.31 | Professional | None | $1.58 | $2.45 | $3.31 |
DeanCare Setting Facility Modifier None Typical Low $1.82 Median $1.82 Typical High $4.27 | Facility | None | $1.82 | $1.82 | $4.27 |
DeanCare Setting Professional Modifier None Typical Low $1.58 Median $3.63 Typical High $3.63 | Professional | None | $1.58 | $3.63 | $3.63 |
Medica Setting Facility Modifier None Typical Low $1.78 Median $1.78 Typical High $11.48 | Facility | None | $1.78 | $1.78 | $11.48 |
Medica Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $3.63 | Professional | None | $1.78 | $1.78 | $3.63 |
Network Health Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
Prevea360 Setting Facility Modifier None Typical Low $1.82 Median $1.82 Typical High $4.27 | Facility | None | $1.82 | $1.82 | $4.27 |
Prevea360 Setting Professional Modifier None Typical Low $1.58 Median $3.63 Typical High $3.63 | Professional | None | $1.58 | $3.63 | $3.63 |
Quartz Setting Professional Modifier None Typical Low $1.58 Median $2.45 Typical High $5.37 | Professional | None | $1.58 | $2.45 | $5.37 |
Quartz Setting Facility Modifier None Typical Low $2.14 Median $4.90 Typical High $4.90 | Facility | None | $2.14 | $4.90 | $4.90 |
Quartz Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Security Health Setting Professional Modifier None Typical Low $2.14 Median $2.19 Typical High $3.80 | Professional | None | $2.14 | $2.19 | $3.80 |
United Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $2.14 | Professional | None | $1.55 | $1.55 | $2.14 |
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 $0.81 Median $0.81 Typical High $12.59 | Professional | 52 · Reduced service | $0.81 | $0.81 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.33 Typical High $6.46 | Professional | 53 · Discontinued | $0.33 | $0.33 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $4.79 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $3.24 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $3.24 |
Where Wisconsin sits
The same service costs 3.3 times more in Texas than in Maryland. 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
$1.91
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.