How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $64.57 | Professional | None | $17.78 | $17.78 | $64.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $8.91 Typical High $32.36 | Professional | 52 · Reduced service | $8.91 | $8.91 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $12.88 | Professional | 53 · Discontinued | $3.55 | $3.55 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $9.55 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $6.46 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $6.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | None | $51.29 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $15.85 | Professional | None | $7.76 | $7.76 | $15.85 |
DeanCare Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $25.12 | Facility | None | $14.13 | $14.13 | $25.12 |
DeanCare Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $67.61 | Professional | None | $46.77 | $54.95 | $67.61 |
Medica Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $89.13 | Facility | None | $14.13 | $14.13 | $89.13 |
Medica Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Prevea360 Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $25.12 | Facility | None | $14.13 | $14.13 | $25.12 |
Quartz Setting Professional Modifier None Typical Low $19.50 Median $20.89 Typical High $31.62 | Professional | None | $19.50 | $20.89 | $31.62 |
Quartz Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Quartz Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $10.72 | Professional | None | $7.76 | $7.76 | $10.72 |
United Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
2 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $7.08 | Professional | RR · Rental | $6.61 | $6.61 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | UE · Used equipment | $48.98 | $48.98 | $48.98 |
Where Wisconsin sits
The same service costs 27.5 times more in Kansas than in South Carolina. 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· 24th of 51
$17.78
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.