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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $870.96 | Professional | None | $81.28 | $81.28 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $173.78 | Professional | None | $158.49 | $158.49 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $331.13 Typical High $501.19 | Facility | None | $56.23 | $331.13 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $173.78 | Professional | None | $41.69 | $56.23 | $173.78 |
DeanCare Setting Facility Modifier None Typical Low $60.26 Median $112.20 Typical High $144.54 | Facility | None | $60.26 | $112.20 | $144.54 |
DeanCare Setting Professional Modifier None Typical Low $144.54 Median $416.87 Typical High $426.58 | Professional | None | $144.54 | $416.87 | $426.58 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $134.90 Typical High $645.65 | Facility | None | $61.66 | $134.90 | $645.65 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $257.04 | Professional | None | $70.79 | $100.00 | $257.04 |
Prevea360 Setting Facility Modifier None Typical Low $60.26 Median $112.20 Typical High $144.54 | Facility | None | $60.26 | $112.20 | $144.54 |
Prevea360 Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Quartz Setting Professional Modifier None Typical Low $134.90 Median $263.03 Typical High $380.19 | Professional | None | $134.90 | $263.03 | $380.19 |
Quartz Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Quartz Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
United Setting Professional Modifier None Typical Low $53.70 Median $91.20 Typical High $134.90 | Professional | None | $53.70 | $91.20 | $134.90 |
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 $40.74 Median $40.74 Typical High $436.52 | Professional | 52 · Reduced service | $40.74 | $40.74 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $173.78 | Professional | 53 · Discontinued | $16.22 | $16.22 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $128.82 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $87.10 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $87.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $158.49 | Professional | RR · Rental | $15.85 | $15.85 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | UE · Used equipment | $117.49 | $117.49 | $117.49 |
Where Wisconsin sits
The same service costs 4.9 times more in North Dakota 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· 22nd of 51
$100
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.