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 $3.47 Median $3.47 Typical High $70.79 | Facility | None | $3.47 | $3.47 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $134.90 | Professional | None | $3.47 | $3.47 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Facility | None | $4.17 | $4.17 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $3.72 Typical High $5.01 | Professional | None | $3.39 | $3.72 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $5.25 Median $10.23 Typical High $14.13 | Facility | None | $5.25 | $10.23 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $6.03 Typical High $9.33 | Professional | None | $3.39 | $6.03 | $9.33 |
DeanCare Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $11.48 | Facility | None | $5.01 | $5.01 | $11.48 |
DeanCare Setting Professional Modifier None Typical Low $7.59 Median $10.00 Typical High $10.00 | Professional | None | $7.59 | $10.00 | $10.00 |
Medica Setting Facility Modifier None Typical Low $5.25 Median $45.71 Typical High $128.82 | Facility | None | $5.25 | $45.71 | $128.82 |
Medica Setting Professional Modifier None Typical Low $5.25 Median $6.76 Typical High $57.54 | Professional | None | $5.25 | $6.76 | $57.54 |
Network Health Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Prevea360 Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $11.48 | Facility | None | $5.01 | $5.01 | $11.48 |
Prevea360 Setting Professional Modifier None Typical Low $7.59 Median $10.00 Typical High $10.00 | Professional | None | $7.59 | $10.00 | $10.00 |
Quartz Setting Professional Modifier None Typical Low $3.39 Median $11.75 Typical High $48.98 | Professional | None | $3.39 | $11.75 | $48.98 |
Quartz Setting Facility Modifier None Typical Low $5.50 Median $10.23 Typical High $10.23 | Facility | None | $5.50 | $10.23 | $10.23 |
Quartz Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Security Health Setting Professional Modifier None Typical Low $4.57 Median $4.68 Typical High $15.49 | Professional | None | $4.57 | $4.68 | $15.49 |
United Setting Professional Modifier None Typical Low $30.90 Median $33.88 Typical High $81.28 | Professional | None | $30.90 | $33.88 | $81.28 |
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 $1.74 Median $1.74 Typical High $67.61 | Professional | 52 · Reduced service | $1.74 | $1.74 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.69 Typical High $26.92 | Professional | 53 · Discontinued | $0.69 | $0.69 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $20.42 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $13.49 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $13.49 |
Where Wisconsin sits
The same service costs 9.1 times more in Rhode Island than in Florida. 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· 30th of 51
$5.25
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.