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 $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $234.42 | Professional | None | $35.48 | $35.48 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $57.54 Typical High $83.18 | Facility | None | $50.12 | $57.54 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $50.12 Typical High $61.66 | Professional | None | $26.92 | $50.12 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $102.33 Typical High $208.93 | Facility | None | $27.54 | $102.33 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $29.51 Typical High $95.50 | Professional | None | $19.95 | $29.51 | $95.50 |
DeanCare Setting Facility Modifier None Typical Low $14.13 Median $48.98 Typical High $56.23 | Facility | None | $14.13 | $48.98 | $56.23 |
DeanCare Setting Professional Modifier None Typical Low $48.98 Median $69.18 Typical High $72.44 | Professional | None | $48.98 | $69.18 | $72.44 |
Medica Setting Facility Modifier None Typical Low $24.55 Median $48.98 Typical High $229.09 | Facility | None | $24.55 | $48.98 | $229.09 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $30.90 Typical High $63.10 | Professional | None | $21.88 | $30.90 | $63.10 |
Network Health Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Network Health Setting Professional Modifier None Typical Low $35.48 Median $45.71 Typical High $85.11 | Professional | None | $35.48 | $45.71 | $85.11 |
Prevea360 Setting Facility Modifier None Typical Low $14.13 Median $48.98 Typical High $56.23 | Facility | None | $14.13 | $48.98 | $56.23 |
Prevea360 Setting Professional Modifier None Typical Low $28.18 Median $47.86 Typical High $48.98 | Professional | None | $28.18 | $47.86 | $48.98 |
Quartz Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $112.20 | Professional | None | $48.98 | $75.86 | $112.20 |
Quartz Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Quartz Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Security Health Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $45.71 | Professional | None | $38.90 | $45.71 | $45.71 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $16.98 Median $24.55 Typical High $41.69 | Professional | None | $16.98 | $24.55 | $41.69 |
6 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 $17.78 Median $17.78 Typical High $117.49 | Professional | 52 · Reduced service | $17.78 | $17.78 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $47.86 | Professional | 53 · Discontinued | $7.08 | $7.08 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $35.48 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $23.44 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $23.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $2.69 Typical High $3.47 | Professional | RR · Rental | $2.69 | $2.69 | $3.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | UE · Used equipment | $19.95 | $19.95 | $21.88 |
Where Wisconsin sits
The same service costs 2.6 times more in Montana 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· 5th of 51
$46.77
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.