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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $660.69 | Professional | None | $245.47 | $245.47 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $275.42 Typical High $416.87 | Facility | None | $251.19 | $275.42 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $338.84 | Professional | None | $234.42 | $251.19 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $691.83 Typical High $1,071.52 | Facility | None | $194.98 | $691.83 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $478.63 | Professional | None | $165.96 | $208.93 | $478.63 |
DeanCare Setting Facility Modifier None Typical Low $75.86 Median $245.47 Typical High $288.40 | Facility | None | $75.86 | $245.47 | $288.40 |
DeanCare Setting Professional Modifier None Typical Low $269.15 Median $467.74 Typical High $489.78 | Professional | None | $269.15 | $467.74 | $489.78 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $245.47 Typical High $1,148.15 | Facility | None | $125.89 | $245.47 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $1,318.26 | Professional | None | $114.82 | $177.83 | $1,318.26 |
Network Health Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $436.52 | Professional | None | $177.83 | $234.42 | $436.52 |
Prevea360 Setting Facility Modifier None Typical Low $75.86 Median $245.47 Typical High $288.40 | Facility | None | $75.86 | $245.47 | $288.40 |
Prevea360 Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $275.42 | Professional | None | $141.25 | $245.47 | $275.42 |
Quartz Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $602.56 | Professional | None | $251.19 | $380.19 | $602.56 |
Quartz Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Quartz Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
United Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $213.80 | Professional | None | $97.72 | $165.96 | $213.80 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $102.33 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $69.18 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $69.18 |
Where Wisconsin sits
The same service costs 2.6 times more in Montana than in New York. 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· 6th of 51
$245
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.