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 $2.04 Median $2.04 Typical High $4.07 | Facility | None | $2.04 | $2.04 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $2.00 Median $2.04 Typical High $5.01 | Professional | None | $2.00 | $2.04 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $3.02 | Professional | None | $2.00 | $2.00 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $4.90 Typical High $6.03 | Facility | None | $2.95 | $4.90 | $6.03 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $3.16 | Professional | None | $2.00 | $2.00 | $3.16 |
DeanCare Setting Facility Modifier None Typical Low $1.00 Median $2.09 Typical High $2.09 | Facility | None | $1.00 | $2.09 | $2.09 |
DeanCare Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $4.27 | Professional | None | $1.78 | $1.78 | $4.27 |
Medica Setting Facility Modifier None Typical Low $1.00 Median $1.58 Typical High $1.78 | Facility | None | $1.00 | $1.58 | $1.78 |
Medica Setting Professional Modifier None Typical Low $1.58 Median $1.74 Typical High $2.34 | Professional | None | $1.58 | $1.74 | $2.34 |
Network Health Setting Facility Modifier None Typical Low $1.45 Median $1.45 Typical High $1.45 | Facility | None | $1.45 | $1.45 | $1.45 |
Network Health Setting Professional Modifier None Typical Low $1.70 Median $1.91 Typical High $1.91 | Professional | None | $1.70 | $1.91 | $1.91 |
Prevea360 Setting Facility Modifier None Typical Low $1.00 Median $2.09 Typical High $2.09 | Facility | None | $1.00 | $2.09 | $2.09 |
Prevea360 Setting Professional Modifier None Typical Low $3.16 Median $4.27 Typical High $4.27 | Professional | None | $3.16 | $4.27 | $4.27 |
Quartz Setting Professional Modifier None Typical Low $2.00 Median $2.82 Typical High $5.13 | Professional | None | $2.00 | $2.82 | $5.13 |
Quartz Setting Facility Modifier None Typical Low $3.31 Median $6.03 Typical High $6.03 | Facility | None | $3.31 | $6.03 | $6.03 |
Quartz Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Security Health Setting Professional Modifier None Typical Low $1.32 Median $2.51 Typical High $2.75 | Professional | None | $1.32 | $2.51 | $2.75 |
United Setting Professional Modifier None Typical Low $1.78 Median $1.95 Typical High $2.29 | Professional | None | $1.78 | $1.95 | $2.29 |
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 $1.00 Median $1.02 Typical High $2.51 | Professional | 52 · Reduced service | $1.00 | $1.02 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.41 Typical High $1.00 | Professional | 53 · Discontinued | $0.40 | $0.41 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.31 Typical High $0.76 | Professional | 55 · Aftercare only | $0.30 | $0.31 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.21 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.20 | $0.21 | $0.50 |
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· 10th of 51
$2.00
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.