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 $0.33 Median $0.33 Typical High $0.74 | Facility | None | $0.33 | $0.33 | $0.74 |
Aetna Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $2.00 | Professional | None | $0.33 | $0.33 | $2.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $1.15 | Professional | None | $0.34 | $0.34 | $1.15 |
Cigna Setting Facility Modifier None Typical Low $0.54 Median $1.07 Typical High $1.32 | Facility | None | $0.54 | $1.07 | $1.32 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.52 | Professional | None | $0.35 | $0.35 | $0.52 |
DeanCare Setting Facility Modifier None Typical Low $0.33 Median $0.44 Typical High $0.71 | Facility | None | $0.33 | $0.44 | $0.71 |
DeanCare Setting Professional Modifier None Typical Low $0.07 Median $0.26 Typical High $0.72 | Professional | None | $0.07 | $0.26 | $0.72 |
Medica Setting Facility Modifier None Typical Low $0.33 Median $0.71 Typical High $7.24 | Facility | None | $0.33 | $0.71 | $7.24 |
Medica Setting Professional Modifier None Typical Low $0.35 Median $0.46 Typical High $41.69 | Professional | None | $0.35 | $0.46 | $41.69 |
Network Health Setting Facility Modifier None Typical Low $0.10 Median $0.63 Typical High $0.63 | Facility | None | $0.10 | $0.63 | $0.63 |
Network Health Setting Professional Modifier None Typical Low $0.06 Median $0.40 Typical High $0.71 | Professional | None | $0.06 | $0.40 | $0.71 |
Prevea360 Setting Facility Modifier None Typical Low $0.33 Median $0.44 Typical High $0.71 | Facility | None | $0.33 | $0.44 | $0.71 |
Prevea360 Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Quartz Setting Professional Modifier None Typical Low $0.06 Median $0.60 Typical High $0.91 | Professional | None | $0.06 | $0.60 | $0.91 |
Quartz Setting Facility Modifier None Typical Low $0.47 Median $1.07 Typical High $1.07 | Facility | None | $0.47 | $1.07 | $1.07 |
Quartz Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Security Health Setting Professional Modifier None Typical Low $0.04 Median $0.49 Typical High $0.62 | Professional | None | $0.04 | $0.49 | $0.62 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.47 | Professional | None | $0.34 | $0.34 | $0.47 |
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 $0.17 Median $0.17 Typical High $1.00 | Professional | 52 · Reduced service | $0.17 | $0.17 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.40 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.30 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.20 |
Where Wisconsin sits
The same service costs 1.6 times more in Montana than in Michigan. 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· 10th of 51
$0.35
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.