How much rates vary
Facilitymedian $62 · 10th to 90th $36 to $115Professionalmedian $39 · 10th to 90th $37 to $91
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 $38.90 Median $38.90 Typical High $85.11 | Facility | None | $38.90 | $38.90 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.90 Typical High $134.90 | Professional | None | $38.02 | $38.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $79.43 | Facility | None | $46.77 | $46.77 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $56.23 | Professional | None | $38.02 | $38.02 | $56.23 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $56.23 | Professional | None | $36.31 | $36.31 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $91.20 Typical High $114.82 | Facility | None | $58.88 | $91.20 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $60.26 | Professional | None | $38.02 | $38.02 | $60.26 |
DeanCare Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $79.43 | Facility | None | $36.31 | $36.31 | $79.43 |
DeanCare Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $72.44 | Professional | None | $38.90 | $38.90 | $72.44 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $79.43 | Facility | None | $36.31 | $36.31 | $79.43 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $154.88 | Professional | None | $36.31 | $42.66 | $154.88 |
Network Health Setting Facility Modifier None Typical Low $34.67 Median $36.31 Typical High $36.31 | Facility | None | $34.67 | $36.31 | $36.31 |
Network Health Setting Professional Modifier None Typical Low $37.15 Median $41.69 Typical High $41.69 | Professional | None | $37.15 | $41.69 | $41.69 |
Prevea360 Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $79.43 | Facility | None | $36.31 | $36.31 | $79.43 |
Prevea360 Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $72.44 | Professional | None | $54.95 | $72.44 | $72.44 |
Quartz Setting Professional Modifier None Typical Low $38.02 Median $58.88 Typical High $93.33 | Professional | None | $38.02 | $58.88 | $93.33 |
Quartz Setting Facility Modifier None Typical Low $61.66 Median $114.82 Typical High $114.82 | Facility | None | $61.66 | $114.82 | $114.82 |
Quartz Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Security Health Setting Professional Modifier None Typical Low $37.15 Median $51.29 Typical High $54.95 | Professional | None | $37.15 | $51.29 | $54.95 |
United Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $46.77 | Professional | None | $37.15 | $40.74 | $46.77 |
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 $19.05 Median $19.50 Typical High $67.61 | Professional | 52 · Reduced service | $19.05 | $19.50 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.76 Typical High $26.92 | Professional | 53 · Discontinued | $7.59 | $7.76 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $20.42 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.89 Typical High $13.49 | Professional | 56 · Pre-op care only | $3.80 | $3.89 | $13.49 |
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· 11th of 51
$38.90
AK $47.86HI $37.15
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.