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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $102.33 | Professional | None | $19.05 | $19.05 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $43.65 | Professional | None | $23.99 | $23.99 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $77.62 Typical High $120.23 | Facility | None | $28.84 | $77.62 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $28.84 Typical High $41.69 | Professional | None | $20.89 | $28.84 | $41.69 |
DeanCare Setting Facility Modifier None Typical Low $14.13 Median $26.30 Typical High $33.88 | Facility | None | $14.13 | $26.30 | $33.88 |
DeanCare Setting Professional Modifier None Typical Low $33.88 Median $77.62 Typical High $81.28 | Professional | None | $33.88 | $77.62 | $81.28 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $31.62 Typical High $151.36 | Facility | None | $14.45 | $31.62 | $151.36 |
Medica Setting Professional Modifier None Typical Low $16.60 Median $23.44 Typical High $60.26 | Professional | None | $16.60 | $23.44 | $60.26 |
Prevea360 Setting Facility Modifier None Typical Low $14.13 Median $26.30 Typical High $33.88 | Facility | None | $14.13 | $26.30 | $33.88 |
Prevea360 Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Quartz Setting Professional Modifier None Typical Low $31.62 Median $58.88 Typical High $85.11 | Professional | None | $31.62 | $58.88 | $85.11 |
Quartz Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Quartz Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $28.84 | Professional | None | $20.89 | $20.89 | $28.84 |
United Setting Professional Modifier None Typical Low $12.59 Median $21.38 Typical High $31.62 | Professional | None | $12.59 | $21.38 | $31.62 |
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 $9.55 Median $9.55 Typical High $51.29 | Professional | 52 · Reduced service | $9.55 | $9.55 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $20.42 | Professional | 53 · Discontinued | $3.80 | $3.80 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $15.49 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $10.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.40 Median $2.40 Typical High $2.57 | Professional | RR · Rental | $2.40 | $2.40 | $2.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17.78 Median $17.78 Typical High $23.99 | Professional | UE · Used equipment | $17.78 | $17.78 | $23.99 |
Where Wisconsin sits
The same service costs 4.1 times more in Wyoming than in Utah. 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· 28th of 51
$23.99
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.