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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $223.87 | Professional | None | $34.67 | $34.67 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $72.44 | Professional | None | $50.12 | $50.12 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $138.04 Typical High $213.80 | Facility | None | $50.12 | $138.04 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $74.13 | Professional | None | $36.31 | $50.12 | $74.13 |
DeanCare Setting Facility Modifier None Typical Low $25.12 Median $46.77 Typical High $60.26 | Facility | None | $25.12 | $46.77 | $60.26 |
DeanCare Setting Professional Modifier None Typical Low $42.66 Median $54.95 Typical High $61.66 | Professional | None | $42.66 | $54.95 | $61.66 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $56.23 Typical High $269.15 | Facility | None | $25.70 | $56.23 | $269.15 |
Medica Setting Professional Modifier None Typical Low $29.51 Median $41.69 Typical High $109.65 | Professional | None | $29.51 | $41.69 | $109.65 |
Prevea360 Setting Facility Modifier None Typical Low $25.12 Median $46.77 Typical High $60.26 | Facility | None | $25.12 | $46.77 | $60.26 |
Prevea360 Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Quartz Setting Professional Modifier None Typical Low $56.23 Median $107.15 Typical High $151.36 | Professional | None | $56.23 | $107.15 | $151.36 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Quartz Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
United Setting Professional Modifier None Typical Low $22.39 Median $38.02 Typical High $56.23 | Professional | None | $22.39 | $38.02 | $56.23 |
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 $17.38 Median $17.38 Typical High $112.20 | Professional | 52 · Reduced service | $17.38 | $17.38 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $44.67 | Professional | 53 · Discontinued | $6.92 | $6.92 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $33.88 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $22.39 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $5.37 | Professional | RR · Rental | $5.01 | $5.01 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | UE · Used equipment | $37.15 | $37.15 | $37.15 |
Where Wisconsin sits
The same service costs 4.1 times more in Kansas than in Colorado. 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· 14th of 51
$50.12
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.