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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $407.38 | Professional | None | $100.00 | $169.82 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $181.97 Typical High $549.54 | Professional | None | $97.72 | $181.97 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $295.12 Typical High $436.52 | Facility | None | $257.04 | $295.12 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $177.83 | Professional | None | $81.28 | $81.28 | $177.83 |
DeanCare Setting Facility Modifier None Typical Low $93.33 Median $104.71 Typical High $204.17 | Facility | None | $93.33 | $104.71 | $204.17 |
DeanCare Setting Professional Modifier None Typical Low $104.71 Median $269.15 Typical High $346.74 | Professional | None | $104.71 | $269.15 | $346.74 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $104.71 Typical High $204.17 | Facility | None | $93.33 | $104.71 | $204.17 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $251.19 Typical High $741.31 | Professional | None | $107.15 | $251.19 | $741.31 |
Network Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $331.13 | Professional | None | $316.23 | $316.23 | $331.13 |
Prevea360 Setting Facility Modifier None Typical Low $93.33 Median $104.71 Typical High $204.17 | Facility | None | $93.33 | $104.71 | $204.17 |
Prevea360 Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Quartz Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $281.84 | Professional | None | $104.71 | $190.55 | $281.84 |
Quartz Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
United Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $380.19 | Professional | None | $95.50 | $173.78 | $380.19 |
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 $50.12 Median $85.11 Typical High $204.17 | Professional | 52 · Reduced service | $50.12 | $85.11 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $33.88 Typical High $81.28 | Professional | 53 · Discontinued | $19.95 | $33.88 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $25.12 Typical High $61.66 | Professional | 55 · Aftercare only | $14.79 | $25.12 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $16.98 Typical High $40.74 | Professional | 56 · Pre-op care only | $10.00 | $16.98 | $40.74 |
Where Wisconsin sits
The same service costs 3.3 times more in Alaska than in Wyoming. 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· 4th of 51
$170
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.