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 $40.74 Median $40.74 Typical High $91.20 | Facility | None | $40.74 | $40.74 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $151.36 | Professional | None | $40.74 | $40.74 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $57.54 Typical High $190.55 | Professional | None | $35.48 | $57.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $91.20 Typical High $114.82 | Facility | None | $46.77 | $91.20 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $66.07 | Professional | None | $30.20 | $30.20 | $66.07 |
DeanCare Setting Facility Modifier None Typical Low $34.67 Median $38.90 Typical High $43.65 | Facility | None | $34.67 | $38.90 | $43.65 |
DeanCare Setting Professional Modifier None Typical Low $38.90 Median $107.15 Typical High $138.04 | Professional | None | $38.90 | $107.15 | $138.04 |
Medica Setting Facility Modifier None Typical Low $34.67 Median $38.90 Typical High $43.65 | Facility | None | $34.67 | $38.90 | $43.65 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $229.09 | Professional | None | $40.74 | $47.86 | $229.09 |
Prevea360 Setting Facility Modifier None Typical Low $34.67 Median $38.90 Typical High $43.65 | Facility | None | $34.67 | $38.90 | $43.65 |
Prevea360 Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Quartz Setting Professional Modifier None Typical Low $38.90 Median $74.13 Typical High $104.71 | Professional | None | $38.90 | $74.13 | $104.71 |
Quartz Setting Facility Modifier None Typical Low $39.81 Median $91.20 Typical High $91.20 | Facility | None | $39.81 | $91.20 | $91.20 |
Quartz Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Security Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $117.49 | Professional | None | $63.10 | $63.10 | $117.49 |
United Setting Professional Modifier None Typical Low $40.74 Median $43.65 Typical High $51.29 | Professional | None | $40.74 | $43.65 | $51.29 |
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 $20.42 Median $20.42 Typical High $75.86 | Professional | 52 · Reduced service | $20.42 | $20.42 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $30.90 | Professional | 53 · Discontinued | $8.13 | $8.13 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $22.91 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $15.14 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $15.14 |
Where Wisconsin sits
The same service costs 2.0 times more in Alaska than in New Mexico. 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
$43.65
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.