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 $0.02 Median $0.02 Typical High $0.04 | Facility | None | $0.02 | $0.02 | $0.04 |
Aetna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.04 | Professional | None | $0.02 | $0.02 | $0.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
CareSource Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Cigna Setting Facility Modifier None Typical Low $0.03 Median $0.06 Typical High $0.10 | Facility | None | $0.03 | $0.06 | $0.10 |
Cigna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.04 | Professional | None | $0.02 | $0.02 | $0.04 |
DeanCare Setting Facility Modifier None Typical Low $0.33 Median $0.33 Typical High $0.71 | Facility | None | $0.33 | $0.33 | $0.71 |
DeanCare Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.10 | Professional | None | $0.02 | $0.02 | $0.10 |
Medica Setting Facility Modifier None Typical Low $0.54 Median $0.72 Typical High $9.33 | Facility | None | $0.54 | $0.72 | $9.33 |
Medica Setting Professional Modifier None Typical Low $0.02 Median $0.46 Typical High $4.90 | Professional | None | $0.02 | $0.46 | $4.90 |
Network Health Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.04 | Professional | None | $0.02 | $0.02 | $0.04 |
Prevea360 Setting Facility Modifier None Typical Low $0.33 Median $0.33 Typical High $0.71 | Facility | None | $0.33 | $0.33 | $0.71 |
Quartz Setting Professional Modifier None Typical Low $0.04 Median $0.60 Typical High $0.91 | Professional | None | $0.04 | $0.60 | $0.91 |
Quartz Setting Facility Modifier None Typical Low $0.03 Median $0.06 Typical High $0.06 | Facility | None | $0.03 | $0.06 | $0.06 |
Quartz Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Security Health Setting Professional Modifier None Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | None | $0.03 | $0.03 | $0.03 |
The Alliance Setting Professional Modifier None Typical Low $0.45 Median $0.71 Typical High $0.83 | Professional | None | $0.45 | $0.71 | $0.83 |
United Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | None | $0.02 | $0.02 | $0.03 |
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 $1.00 Median $1.51 Typical High $5.50 | Professional | 52 · Reduced service | $1.00 | $1.51 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.60 Typical High $2.19 | Professional | 53 · Discontinued | $0.40 | $0.60 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.45 Typical High $1.66 | Professional | 55 · Aftercare only | $0.30 | $0.45 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.30 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.20 | $0.30 | $1.10 |
Where Wisconsin sits
The same service costs 6.0 times more in Wyoming than in Massachusetts. 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· 29th of 51
$0.02
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.