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 $4.79 Median $4.79 Typical High $10.23 | Facility | None | $4.79 | $4.79 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $7.08 | Professional | None | $4.79 | $4.79 | $7.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $9.77 | Facility | None | $5.89 | $5.89 | $9.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.68 Median $5.13 Typical High $7.08 | Professional | None | $4.68 | $5.13 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $6.76 Median $10.96 Typical High $14.13 | Facility | None | $6.76 | $10.96 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $5.89 Typical High $8.32 | Professional | None | $4.68 | $5.89 | $8.32 |
DeanCare Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $10.00 | Facility | None | $4.47 | $4.47 | $10.00 |
DeanCare Setting Professional Modifier None Typical Low $6.76 Median $8.91 Typical High $8.91 | Professional | None | $6.76 | $8.91 | $8.91 |
Medica Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $10.00 | Facility | None | $4.57 | $4.57 | $10.00 |
Medica Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $6.92 | Professional | None | $4.57 | $4.57 | $6.92 |
Network Health Setting Facility Modifier None Typical Low $4.37 Median $4.68 Typical High $4.68 | Facility | None | $4.37 | $4.68 | $4.68 |
Prevea360 Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $10.00 | Facility | None | $4.47 | $4.47 | $10.00 |
Prevea360 Setting Professional Modifier None Typical Low $6.76 Median $8.91 Typical High $8.91 | Professional | None | $6.76 | $8.91 | $8.91 |
Quartz Setting Professional Modifier None Typical Low $4.68 Median $7.24 Typical High $10.96 | Professional | None | $4.68 | $7.24 | $10.96 |
Quartz Setting Facility Modifier None Typical Low $6.17 Median $14.13 Typical High $14.13 | Facility | None | $6.17 | $14.13 | $14.13 |
Quartz Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Security Health Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.76 | Professional | None | $6.31 | $6.31 | $7.76 |
United Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $6.17 | Professional | None | $4.47 | $4.47 | $6.17 |
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 $2.40 Median $2.40 Typical High $3.47 | Professional | 52 · Reduced service | $2.40 | $2.40 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.95 Typical High $1.41 | Professional | 53 · Discontinued | $0.95 | $0.95 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $1.05 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.48 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.48 | $0.48 | $0.71 |
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· 9th of 51
$5.37
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.