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 $0.45 Median $0.45 Typical High $1.00 | Facility | None | $0.45 | $0.45 | $1.00 |
Aetna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $38.02 | Professional | None | $0.45 | $0.45 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.47 Median $12.02 Typical High $25.70 | Professional | None | $4.47 | $12.02 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $1.45 Median $3.09 Typical High $12.30 | Facility | None | $1.45 | $3.09 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $0.78 Median $3.98 Typical High $8.91 | Professional | None | $0.78 | $3.98 | $8.91 |
DeanCare Setting Facility Modifier None Typical Low $0.45 Median $5.25 Typical High $10.00 | Facility | None | $0.45 | $5.25 | $10.00 |
DeanCare Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Medica Setting Facility Modifier None Typical Low $0.45 Median $5.25 Typical High $10.00 | Facility | None | $0.45 | $5.25 | $10.00 |
Medica Setting Professional Modifier None Typical Low $1.82 Median $4.57 Typical High $6.17 | Professional | None | $1.82 | $4.57 | $6.17 |
Prevea360 Setting Facility Modifier None Typical Low $0.45 Median $5.25 Typical High $10.00 | Facility | None | $0.45 | $5.25 | $10.00 |
Prevea360 Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Quartz Setting Professional Modifier None Typical Low $5.25 Median $10.47 Typical High $14.79 | Professional | None | $5.25 | $10.47 | $14.79 |
Quartz Setting Facility Modifier None Typical Low $5.37 Median $12.30 Typical High $12.30 | Facility | None | $5.37 | $12.30 | $12.30 |
Quartz Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Security Health Setting Professional Modifier None Typical Low $8.32 Median $9.77 Typical High $15.49 | Professional | None | $8.32 | $9.77 | $15.49 |
United Setting Professional Modifier None Typical Low $1.86 Median $4.68 Typical High $6.46 | Professional | None | $1.86 | $4.68 | $6.46 |
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 $0.23 Median $0.23 Typical High $20.89 | Professional | 52 · Reduced service | $0.23 | $0.23 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $8.32 | Professional | 53 · Discontinued | $0.09 | $0.09 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $6.31 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $4.17 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $4.17 |
Where Wisconsin sits
The same service costs 58.9 times more in Montana than in Hawaii. 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· 2nd of 51
$5.62
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.