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 $3.80 Median $3.80 Typical High $8.32 | Facility | None | $3.80 | $3.80 | $8.32 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $8.91 | Professional | None | $3.80 | $3.80 | $8.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $7.76 | Facility | None | $4.68 | $4.68 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.72 Median $4.07 Typical High $5.62 | Professional | None | $3.72 | $4.07 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $8.91 Typical High $11.22 | Facility | None | $5.37 | $8.91 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $4.68 Typical High $6.61 | Professional | None | $3.72 | $4.68 | $6.61 |
DeanCare Setting Facility Modifier None Typical Low $2.63 Median $3.63 Typical High $7.76 | Facility | None | $2.63 | $3.63 | $7.76 |
DeanCare Setting Professional Modifier None Typical Low $5.37 Median $7.24 Typical High $7.24 | Professional | None | $5.37 | $7.24 | $7.24 |
Medica Setting Facility Modifier None Typical Low $2.63 Median $3.63 Typical High $7.76 | Facility | None | $2.63 | $3.63 | $7.76 |
Medica Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $5.50 | Professional | None | $3.63 | $3.63 | $5.50 |
Network Health Setting Facility Modifier None Typical Low $3.55 Median $3.72 Typical High $3.72 | Facility | None | $3.55 | $3.72 | $3.72 |
Prevea360 Setting Facility Modifier None Typical Low $2.63 Median $3.63 Typical High $7.76 | Facility | None | $2.63 | $3.63 | $7.76 |
Prevea360 Setting Professional Modifier None Typical Low $5.37 Median $7.24 Typical High $7.24 | Professional | None | $5.37 | $7.24 | $7.24 |
Quartz Setting Professional Modifier None Typical Low $3.72 Median $5.75 Typical High $9.33 | Professional | None | $3.72 | $5.75 | $9.33 |
Quartz Setting Facility Modifier None Typical Low $4.90 Median $11.22 Typical High $11.22 | Facility | None | $4.90 | $11.22 | $11.22 |
Quartz Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Security Health Setting Professional Modifier None Typical Low $4.79 Median $5.01 Typical High $6.17 | Professional | None | $4.79 | $5.01 | $6.17 |
United Setting Facility Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.90 | Professional | None | $3.55 | $3.55 | $4.90 |
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 $1.91 Median $1.91 Typical High $4.47 | Professional | 52 · Reduced service | $1.91 | $1.91 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.76 Typical High $1.82 | Professional | 53 · Discontinued | $0.76 | $0.76 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $1.35 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.38 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.38 | $0.38 | $0.89 |
Where Wisconsin sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 6th of 51
$4.27
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.