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 $1.55 Median $1.55 Typical High $3.47 | Facility | None | $1.55 | $1.55 | $3.47 |
Aetna Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $10.00 | Professional | None | $1.55 | $1.55 | $10.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.91 Median $1.91 Typical High $3.24 | Facility | None | $1.91 | $1.91 | $3.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.51 Median $1.66 Typical High $2.29 | Professional | None | $1.51 | $1.66 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $2.24 Median $3.72 Typical High $4.57 | Facility | None | $2.24 | $3.72 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $1.51 Median $1.91 Typical High $2.82 | Professional | None | $1.51 | $1.91 | $2.82 |
DeanCare Setting Facility Modifier None Typical Low $1.32 Median $1.51 Typical High $3.55 | Facility | None | $1.32 | $1.51 | $3.55 |
DeanCare Setting Professional Modifier None Typical Low $0.79 Median $3.02 Typical High $3.02 | Professional | None | $0.79 | $3.02 | $3.02 |
Medica Setting Facility Modifier None Typical Low $1.32 Median $1.51 Typical High $3.55 | Facility | None | $1.32 | $1.51 | $3.55 |
Medica Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $2.29 | Professional | None | $1.51 | $1.51 | $2.29 |
Network Health Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $3.16 | Facility | None | $1.58 | $1.58 | $3.16 |
Prevea360 Setting Facility Modifier None Typical Low $1.32 Median $1.51 Typical High $3.55 | Facility | None | $1.32 | $1.51 | $3.55 |
Prevea360 Setting Professional Modifier None Typical Low $0.79 Median $3.02 Typical High $3.02 | Professional | None | $0.79 | $3.02 | $3.02 |
Quartz Setting Professional Modifier None Typical Low $1.51 Median $2.40 Typical High $4.27 | Professional | None | $1.51 | $2.40 | $4.27 |
Quartz Setting Facility Modifier None Typical Low $2.00 Median $4.57 Typical High $4.57 | Facility | None | $2.00 | $4.57 | $4.57 |
Quartz Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
Security Health Setting Professional Modifier None Typical Low $1.62 Median $2.04 Typical High $2.51 | Professional | None | $1.62 | $2.04 | $2.51 |
United Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $2.04 | Professional | None | $1.51 | $1.51 | $2.04 |
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 $0.78 Median $0.78 Typical High $5.01 | Professional | 52 · Reduced service | $0.78 | $0.78 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.31 Median $0.31 Typical High $2.00 | Professional | 53 · Discontinued | $0.31 | $0.31 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $1.51 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $1.00 |
Where Wisconsin sits
The same service costs 1.7 times more in Arizona than in North 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· 8th of 51
$1.78
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.