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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $26.30 | Professional | None | $6.31 | $6.31 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $52.48 Typical High $79.43 | Facility | None | $14.13 | $52.48 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $30.90 | Professional | None | $12.02 | $14.13 | $30.90 |
DeanCare Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $25.70 | Facility | None | $14.45 | $14.45 | $25.70 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $21.38 Typical High $89.13 | Facility | None | $14.45 | $21.38 | $89.13 |
Medica Setting Professional Modifier None Typical Low $10.47 Median $15.49 Typical High $19.05 | Professional | None | $10.47 | $15.49 | $19.05 |
Prevea360 Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $25.70 | Facility | None | $14.45 | $14.45 | $25.70 |
Quartz Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Quartz Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $14.13 | Professional | None | $12.02 | $12.02 | $14.13 |
United Setting Professional Modifier None Typical Low $8.13 Median $14.45 Typical High $19.05 | Professional | None | $8.13 | $14.45 | $19.05 |
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 $21.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.65 Median $0.65 Typical High $0.69 | Professional | RR · Rental | $0.65 | $0.65 | $0.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | UE · Used equipment | $4.79 | $4.79 | $4.79 |
Where Wisconsin sits
The same service costs 2.7 times more in North Dakota than in Ohio. 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· 16th of 51
$14.45
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.