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 $1.12 Median $1.12 Typical High $2.51 | Facility | None | $1.12 | $1.12 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $3.02 | Professional | None | $1.12 | $1.12 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Facility | None | $1.35 | $1.35 | $1.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.10 Median $1.26 Typical High $3.24 | Professional | None | $1.10 | $1.26 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $1.58 Median $2.63 Typical High $3.31 | Facility | None | $1.58 | $2.63 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.41 Typical High $1.95 | Professional | None | $1.10 | $1.41 | $1.95 |
DeanCare Setting Facility Modifier None Typical Low $1.35 Median $1.35 Typical High $2.88 | Facility | None | $1.35 | $1.35 | $2.88 |
DeanCare Setting Professional Modifier None Typical Low $2.04 Median $2.69 Typical High $3.47 | Professional | None | $2.04 | $2.69 | $3.47 |
Medica Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $2.88 | Facility | None | $1.29 | $1.29 | $2.88 |
Medica Setting Professional Modifier None Typical Low $0.51 Median $1.29 Typical High $1.91 | Professional | None | $0.51 | $1.29 | $1.91 |
Network Health Setting Facility Modifier None Typical Low $1.07 Median $1.07 Typical High $1.07 | Facility | None | $1.07 | $1.07 | $1.07 |
Network Health Setting Professional Modifier None Typical Low $1.35 Median $1.48 Typical High $1.70 | Professional | None | $1.35 | $1.48 | $1.70 |
Prevea360 Setting Facility Modifier None Typical Low $1.35 Median $1.35 Typical High $2.88 | Facility | None | $1.35 | $1.35 | $2.88 |
Prevea360 Setting Professional Modifier None Typical Low $2.04 Median $2.69 Typical High $3.47 | Professional | None | $2.04 | $2.69 | $3.47 |
Quartz Setting Professional Modifier None Typical Low $1.10 Median $1.78 Typical High $5.75 | Professional | None | $1.10 | $1.78 | $5.75 |
Quartz Setting Facility Modifier None Typical Low $1.45 Median $3.31 Typical High $3.31 | Facility | None | $1.45 | $3.31 | $3.31 |
Quartz Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Security Health Setting Professional Modifier None Typical Low $1.48 Median $1.82 Typical High $2.82 | Professional | None | $1.48 | $1.82 | $2.82 |
United Setting Professional Modifier None Typical Low $0.44 Median $1.10 Typical High $1.51 | Professional | None | $0.44 | $1.10 | $1.51 |
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 $0.56 Median $0.56 Typical High $3.98 | Professional | 52 · Reduced service | $0.56 | $0.56 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $1.58 | Professional | 53 · Discontinued | $0.22 | $0.22 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $1.20 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.79 |
Where Wisconsin sits
The same service costs 4.3 times more in Wyoming than in Delaware. 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· 8th of 51
$1.29
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.