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 $1.12 Median $1.12 Typical High $1.12 | Facility | None | $1.12 | $1.12 | $1.12 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.12 Typical High $2.00 | Professional | None | $1.00 | $1.12 | $2.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.02 Median $2.69 Typical High $6.76 | Professional | None | $1.02 | $2.69 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $1.02 Typical High $1.51 | Facility | None | $0.89 | $1.02 | $1.51 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.85 Typical High $2.09 | Professional | None | $0.38 | $0.85 | $2.09 |
DeanCare Setting Facility Modifier None Typical Low $0.89 Median $1.45 Typical High $30.90 | Facility | None | $0.89 | $1.45 | $30.90 |
Medica Setting Facility Modifier None Typical Low $0.87 Median $2.57 Typical High $89.13 | Facility | None | $0.87 | $2.57 | $89.13 |
Medica Setting Professional Modifier None Typical Low $1.23 Median $3.02 Typical High $4.27 | Professional | None | $1.23 | $3.02 | $4.27 |
Prevea360 Setting Facility Modifier None Typical Low $0.89 Median $1.45 Typical High $30.90 | Facility | None | $0.89 | $1.45 | $30.90 |
Quartz Setting Professional Modifier None Typical Low $1.12 Median $2.29 Typical High $3.16 | Professional | None | $1.12 | $2.29 | $3.16 |
Quartz Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
United Setting Professional Modifier None Typical Low $1.26 Median $2.82 Typical High $4.27 | Professional | None | $1.26 | $2.82 | $4.27 |
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 $0.50 Median $0.56 Typical High $1.00 | Professional | 52 · Reduced service | $0.50 | $0.56 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.22 Typical High $0.40 | Professional | 53 · Discontinued | $0.20 | $0.22 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.17 Typical High $0.30 | Professional | 55 · Aftercare only | $0.15 | $0.17 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.11 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.10 | $0.11 | $0.20 |
Where Wisconsin sits
The same service costs 104.7 times more in Wyoming than in Connecticut. 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· 5th of 51
$2.00
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.