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 $2.51 Median $2.51 Typical High $5.50 | Facility | None | $2.51 | $2.51 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $19.05 | Professional | None | $2.51 | $2.51 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $5.25 | Facility | None | $3.09 | $3.09 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.45 Median $2.69 Typical High $3.63 | Professional | None | $2.45 | $2.69 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $5.89 Typical High $7.41 | Facility | None | $3.63 | $5.89 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.09 Typical High $4.47 | Professional | None | $2.45 | $3.09 | $4.47 |
DeanCare Setting Facility Modifier None Typical Low $1.38 Median $2.40 Typical High $2.40 | Facility | None | $1.38 | $2.40 | $2.40 |
DeanCare Setting Professional Modifier None Typical Low $1.07 Median $4.79 Typical High $4.79 | Professional | None | $1.07 | $4.79 | $4.79 |
Medica Setting Facility Modifier None Typical Low $1.38 Median $2.45 Typical High $2.45 | Facility | None | $1.38 | $2.45 | $2.45 |
Medica Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.72 | Professional | None | $2.45 | $2.45 | $3.72 |
Network Health Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
Prevea360 Setting Facility Modifier None Typical Low $1.38 Median $2.40 Typical High $2.40 | Facility | None | $1.38 | $2.40 | $2.40 |
Prevea360 Setting Professional Modifier None Typical Low $1.07 Median $4.79 Typical High $4.79 | Professional | None | $1.07 | $4.79 | $4.79 |
Quartz Setting Professional Modifier None Typical Low $2.45 Median $3.72 Typical High $5.89 | Professional | None | $2.45 | $3.72 | $5.89 |
Quartz Setting Facility Modifier None Typical Low $3.24 Median $7.41 Typical High $7.41 | Facility | None | $3.24 | $7.41 | $7.41 |
Quartz Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
Security Health Setting Professional Modifier None Typical Low $2.14 Median $3.31 Typical High $4.07 | Professional | None | $2.14 | $3.31 | $4.07 |
United Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $3.31 | Professional | None | $2.40 | $2.40 | $3.31 |
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 $1.26 Median $1.26 Typical High $9.55 | Professional | 52 · Reduced service | $1.26 | $1.26 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $3.80 | Professional | 53 · Discontinued | $0.50 | $0.50 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.38 Typical High $2.82 | Professional | 55 · Aftercare only | $0.38 | $0.38 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $1.91 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $1.91 |
Where Wisconsin sits
The same service costs 1.7 times more in Arizona than in Iowa. 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
$2.82
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.