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 $5.75 Median $5.75 Typical High $13.49 | Facility | None | $5.75 | $5.75 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.62 Median $6.17 Typical High $8.32 | Professional | None | $5.62 | $6.17 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $8.71 Median $16.98 Typical High $25.70 | Facility | None | $8.71 | $16.98 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $10.23 Typical High $16.98 | Professional | None | $5.62 | $10.23 | $16.98 |
DeanCare Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $16.60 | Facility | None | $6.76 | $6.76 | $16.60 |
DeanCare Setting Professional Modifier None Typical Low $3.47 Median $13.80 Typical High $13.80 | Professional | None | $3.47 | $13.80 | $13.80 |
Medica Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $56.23 | Facility | None | $3.16 | $3.16 | $56.23 |
Medica Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $13.80 | Professional | None | $3.16 | $3.16 | $13.80 |
Network Health Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Prevea360 Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $16.60 | Facility | None | $6.76 | $6.76 | $16.60 |
Prevea360 Setting Professional Modifier None Typical Low $3.47 Median $13.80 Typical High $13.80 | Professional | None | $3.47 | $13.80 | $13.80 |
Quartz Setting Professional Modifier None Typical Low $5.62 Median $9.33 Typical High $42.66 | Professional | None | $5.62 | $9.33 | $42.66 |
Quartz Setting Facility Modifier None Typical Low $7.41 Median $16.98 Typical High $16.98 | Facility | None | $7.41 | $16.98 | $16.98 |
Quartz Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Security Health Setting Professional Modifier None Typical Low $7.59 Median $7.76 Typical High $28.84 | Professional | None | $7.59 | $7.76 | $28.84 |
United Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $7.94 | Professional | None | $5.89 | $5.89 | $7.94 |
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 $2.88 Median $2.88 Typical High $38.90 | Professional | 52 · Reduced service | $2.88 | $2.88 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.15 Typical High $15.49 | Professional | 53 · Discontinued | $1.15 | $1.15 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $11.75 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.58 Typical High $7.76 | Professional | 56 · Pre-op care only | $0.58 | $0.58 | $7.76 |
Where Wisconsin sits
The same service costs 3.2 times more in Oklahoma than in North Dakota. 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
$6.46
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.