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 $1.29 Median $1.29 Typical High $3.16 | Facility | None | $1.29 | $1.29 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $3.02 | Professional | None | $1.29 | $1.29 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $3.02 | Facility | None | $1.55 | $1.55 | $3.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $1.38 Typical High $1.86 | Professional | None | $1.26 | $1.38 | $1.86 |
Cigna Setting Facility Modifier None Typical Low $1.66 Median $2.69 Typical High $3.80 | Facility | None | $1.66 | $2.69 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.45 Typical High $2.04 | Professional | None | $1.26 | $1.45 | $2.04 |
DeanCare Setting Facility Modifier None Typical Low $0.60 Median $1.10 Typical High $1.10 | Facility | None | $0.60 | $1.10 | $1.10 |
DeanCare Setting Professional Modifier None Typical Low $0.54 Median $2.14 Typical High $2.14 | Professional | None | $0.54 | $2.14 | $2.14 |
Medica Setting Facility Modifier None Typical Low $0.60 Median $1.12 Typical High $1.12 | Facility | None | $0.60 | $1.12 | $1.12 |
Medica Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.74 | Professional | None | $1.12 | $1.12 | $1.74 |
Network Health Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.17 | Facility | None | $1.10 | $1.10 | $1.17 |
Prevea360 Setting Facility Modifier None Typical Low $0.60 Median $1.10 Typical High $1.10 | Facility | None | $0.60 | $1.10 | $1.10 |
Prevea360 Setting Professional Modifier None Typical Low $0.54 Median $2.14 Typical High $2.14 | Professional | None | $0.54 | $2.14 | $2.14 |
Quartz Setting Professional Modifier None Typical Low $1.26 Median $1.95 Typical High $2.51 | Professional | None | $1.26 | $1.95 | $2.51 |
Quartz Setting Facility Modifier None Typical Low $1.66 Median $3.80 Typical High $3.80 | Facility | None | $1.66 | $3.80 | $3.80 |
Quartz Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Security Health Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $2.09 | Professional | None | $1.70 | $1.70 | $2.09 |
United Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.91 | Professional | None | $1.38 | $1.38 | $1.91 |
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 $0.65 Median $0.65 Typical High $1.51 | Professional | 52 · Reduced service | $0.65 | $0.65 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $0.60 | Professional | 53 · Discontinued | $0.26 | $0.26 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.45 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.30 |
Where Wisconsin sits
The same service costs 1.7 times more in Arizona than in Oklahoma. 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· 12th of 51
$1.41
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.