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 $1.91 Median $1.91 Typical High $4.27 | Facility | None | $1.91 | $1.91 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $1.91 Typical High $7.94 | Professional | None | $1.86 | $1.91 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Facility | None | $2.34 | $2.34 | $2.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.82 | Professional | None | $1.86 | $1.86 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $4.57 Typical High $5.62 | Facility | None | $2.82 | $4.57 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.75 | Professional | None | $1.86 | $1.86 | $2.75 |
DeanCare Setting Facility Modifier None Typical Low $1.32 Median $1.82 Typical High $4.27 | Facility | None | $1.32 | $1.82 | $4.27 |
DeanCare Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $3.63 | Professional | None | $2.00 | $2.00 | $3.63 |
Medica Setting Facility Modifier None Typical Low $1.32 Median $1.82 Typical High $4.27 | Facility | None | $1.32 | $1.82 | $4.27 |
Medica Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $2.51 | Professional | None | $1.82 | $1.82 | $2.51 |
Network Health Setting Facility Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Facility | None | $1.82 | $1.82 | $1.82 |
Network Health Setting Professional Modifier None Typical Low $1.91 Median $2.14 Typical High $2.14 | Professional | None | $1.91 | $2.14 | $2.14 |
Prevea360 Setting Facility Modifier None Typical Low $1.32 Median $1.82 Typical High $4.27 | Facility | None | $1.32 | $1.82 | $4.27 |
Prevea360 Setting Professional Modifier None Typical Low $2.75 Median $3.63 Typical High $3.63 | Professional | None | $2.75 | $3.63 | $3.63 |
Quartz Setting Professional Modifier None Typical Low $1.86 Median $2.95 Typical High $4.27 | Professional | None | $1.86 | $2.95 | $4.27 |
Quartz Setting Facility Modifier None Typical Low $2.45 Median $5.62 Typical High $5.62 | Facility | None | $2.45 | $5.62 | $5.62 |
Quartz Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Security Health Setting Professional Modifier None Typical Low $1.45 Median $2.34 Typical High $2.57 | Professional | None | $1.45 | $2.34 | $2.57 |
United Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.45 | Professional | None | $1.86 | $1.86 | $2.45 |
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 $0.93 Median $0.95 Typical High $3.98 | Professional | 52 · Reduced service | $0.93 | $0.95 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.38 Typical High $1.58 | Professional | 53 · Discontinued | $0.37 | $0.38 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $1.20 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.79 |
Where Wisconsin sits
Rates are fairly even across states for this service. 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· 25th of 51
$1.86
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.