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 $51.29 Median $51.29 Typical High $112.20 | Facility | None | $51.29 | $51.29 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $371.54 | Professional | None | $51.29 | $51.29 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.18 Median $64.57 Typical High $154.88 | Professional | None | $28.18 | $64.57 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $117.49 Typical High $165.96 | Facility | None | $72.44 | $117.49 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $61.66 | Professional | None | $52.48 | $53.70 | $61.66 |
DeanCare Setting Facility Modifier None Typical Low $28.18 Median $41.69 Typical High $60.26 | Facility | None | $28.18 | $41.69 | $60.26 |
DeanCare Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $41.69 Typical High $190.55 | Facility | None | $28.18 | $41.69 | $190.55 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
Prevea360 Setting Facility Modifier None Typical Low $28.18 Median $41.69 Typical High $60.26 | Facility | None | $28.18 | $41.69 | $60.26 |
Prevea360 Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Quartz Setting Professional Modifier None Typical Low $31.62 Median $58.88 Typical High $89.13 | Professional | None | $31.62 | $58.88 | $89.13 |
Quartz Setting Facility Modifier None Typical Low $72.44 Median $165.96 Typical High $165.96 | Facility | None | $72.44 | $165.96 | $165.96 |
Quartz Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
4 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 $25.12 Median $25.12 Typical High $186.21 | Professional | 52 · Reduced service | $25.12 | $25.12 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $75.86 | Professional | 53 · Discontinued | $10.23 | $10.23 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $56.23 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $37.15 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $37.15 |
Where Wisconsin sits
The same service costs 6.6 times more in Alabama 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· 6th of 51
$60.26
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.