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 $1.38 Median $1.38 Typical High $3.02 | Facility | None | $1.38 | $1.38 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $3.98 | Professional | None | $1.38 | $1.38 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.66 Median $1.66 Typical High $2.82 | Facility | None | $1.66 | $1.66 | $2.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.32 Median $1.45 Typical High $2.00 | Professional | None | $1.32 | $1.45 | $2.00 |
Cigna Setting Facility Modifier None Typical Low $1.95 Median $3.24 Typical High $4.07 | Facility | None | $1.95 | $3.24 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.70 Typical High $2.45 | Professional | None | $1.32 | $1.70 | $2.45 |
DeanCare Setting Facility Modifier None Typical Low $1.00 Median $1.29 Typical High $2.88 | Facility | None | $1.00 | $1.29 | $2.88 |
DeanCare Setting Professional Modifier None Typical Low $1.95 Median $2.57 Typical High $2.57 | Professional | None | $1.95 | $2.57 | $2.57 |
Medica Setting Facility Modifier None Typical Low $1.00 Median $1.26 Typical High $2.88 | Facility | None | $1.00 | $1.26 | $2.88 |
Medica Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $2.09 | Professional | None | $1.26 | $1.26 | $2.09 |
Network Health Setting Facility Modifier None Typical Low $1.26 Median $1.38 Typical High $1.38 | Facility | None | $1.26 | $1.38 | $1.38 |
Prevea360 Setting Facility Modifier None Typical Low $1.00 Median $1.29 Typical High $2.88 | Facility | None | $1.00 | $1.29 | $2.88 |
Prevea360 Setting Professional Modifier None Typical Low $1.95 Median $2.57 Typical High $2.57 | Professional | None | $1.95 | $2.57 | $2.57 |
Quartz Setting Professional Modifier None Typical Low $1.32 Median $2.04 Typical High $3.39 | Professional | None | $1.32 | $2.04 | $3.39 |
Quartz Setting Facility Modifier None Typical Low $1.78 Median $4.07 Typical High $4.07 | Facility | None | $1.78 | $4.07 | $4.07 |
Quartz Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Security Health Setting Professional Modifier None Typical Low $1.62 Median $1.82 Typical High $2.19 | Professional | None | $1.62 | $1.82 | $2.19 |
United Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.82 | Professional | None | $1.32 | $1.32 | $1.82 |
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 $0.69 Median $0.69 Typical High $2.00 | Professional | 52 · Reduced service | $0.69 | $0.69 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.79 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.60 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.40 |
Where Wisconsin sits
The same service costs 1.5 times more in Alaska than in Virginia. 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
$1.51
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.