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 $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $213.80 | Professional | None | $14.79 | $14.79 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $54.95 Typical High $54.95 | Professional | None | $30.90 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $58.88 Typical High $91.20 | Facility | None | $28.18 | $58.88 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $25.70 Typical High $34.67 | Professional | None | $20.42 | $25.70 | $34.67 |
DeanCare Setting Facility Modifier None Typical Low $10.72 Median $19.95 Typical High $25.70 | Facility | None | $10.72 | $19.95 | $25.70 |
DeanCare Setting Professional Modifier None Typical Low $26.30 Median $66.07 Typical High $69.18 | Professional | None | $26.30 | $66.07 | $69.18 |
Medica Setting Facility Modifier None Typical Low $10.96 Median $23.99 Typical High $114.82 | Facility | None | $10.96 | $23.99 | $114.82 |
Medica Setting Professional Modifier None Typical Low $12.88 Median $17.78 Typical High $46.77 | Professional | None | $12.88 | $17.78 | $46.77 |
Prevea360 Setting Facility Modifier None Typical Low $10.72 Median $19.95 Typical High $25.70 | Facility | None | $10.72 | $19.95 | $25.70 |
Prevea360 Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Quartz Setting Professional Modifier None Typical Low $23.99 Median $47.86 Typical High $69.18 | Professional | None | $23.99 | $47.86 | $69.18 |
Quartz Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Quartz Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
United Setting Professional Modifier None Typical Low $9.77 Median $16.22 Typical High $23.99 | Professional | None | $9.77 | $16.22 | $23.99 |
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 $7.41 Median $7.41 Typical High $107.15 | Professional | 52 · Reduced service | $7.41 | $7.41 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $43.65 | Professional | 53 · Discontinued | $2.95 | $2.95 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $32.36 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $21.38 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $21.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $5.89 | Professional | RR · Rental | $5.50 | $5.50 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
Where Wisconsin sits
The same service costs 8.7 times more in Hawaii than in Kansas. 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· 18th of 51
$22.39
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.