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 $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $323.59 | Professional | None | $6.03 | $6.03 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $125.89 Typical High $125.89 | Professional | None | $13.18 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $25.12 Typical High $38.90 | Facility | None | $9.33 | $25.12 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $9.33 Typical High $13.49 | Professional | None | $6.76 | $9.33 | $13.49 |
DeanCare Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $9.12 | Facility | None | $4.57 | $4.57 | $9.12 |
DeanCare Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $33.88 | Professional | None | $28.84 | $33.88 | $33.88 |
Medica Setting Facility Modifier None Typical Low $4.57 Median $8.13 Typical High $89.13 | Facility | None | $4.57 | $8.13 | $89.13 |
Medica Setting Professional Modifier None Typical Low $5.50 Median $7.41 Typical High $10.96 | Professional | None | $5.50 | $7.41 | $10.96 |
Prevea360 Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $9.12 | Facility | None | $4.57 | $4.57 | $9.12 |
Prevea360 Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Quartz Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $158.49 | Professional | None | $97.72 | $104.71 | $158.49 |
Quartz Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Quartz Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $9.33 | Professional | None | $6.76 | $6.76 | $9.33 |
United Setting Professional Modifier None Typical Low $4.17 Median $7.41 Typical High $11.48 | Professional | None | $4.17 | $7.41 | $11.48 |
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 $3.02 Median $3.02 Typical High $162.18 | Professional | 52 · Reduced service | $3.02 | $3.02 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $64.57 | Professional | 53 · Discontinued | $1.23 | $1.23 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $47.86 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $32.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $13.49 | Professional | RR · Rental | $12.59 | $12.59 | $13.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | UE · Used equipment | $93.33 | $93.33 | $93.33 |
Where Wisconsin sits
The same service costs 39.8 times more in New York 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· 22nd of 51
$8.13
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.