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 $35.48 Median $35.48 Typical High $60.26 | Facility | None | $35.48 | $35.48 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $83.18 | Professional | None | $35.48 | $35.48 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $47.86 Typical High $83.18 | Professional | None | $29.51 | $47.86 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $74.13 Typical High $87.10 | Facility | None | $44.67 | $74.13 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $38.02 Typical High $53.70 | Professional | None | $28.84 | $38.02 | $53.70 |
DeanCare Setting Facility Modifier None Typical Low $26.92 Median $30.20 Typical High $30.20 | Facility | None | $26.92 | $30.20 | $30.20 |
DeanCare Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $44.67 | Professional | None | $25.70 | $25.70 | $44.67 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $30.20 Typical High $30.20 | Facility | None | $26.92 | $30.20 | $30.20 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Network Health Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Prevea360 Setting Facility Modifier None Typical Low $26.92 Median $30.20 Typical High $30.20 | Facility | None | $26.92 | $30.20 | $30.20 |
Prevea360 Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $44.67 | Professional | None | $25.70 | $25.70 | $44.67 |
Quartz Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Quartz Setting Facility Modifier None Typical Low $38.02 Median $87.10 Typical High $87.10 | Facility | None | $38.02 | $87.10 | $87.10 |
Quartz Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Security Health Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $50.12 | Professional | None | $40.74 | $40.74 | $50.12 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
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 $17.78 Median $17.78 Typical High $41.69 | Professional | 52 · Reduced service | $17.78 | $17.78 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $16.98 | Professional | 53 · Discontinued | $7.08 | $7.08 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $12.59 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $8.32 |
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· 7th of 51
$37.15
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.