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 $1.95 Median $1.95 Typical High $3.80 | Facility | None | $1.95 | $1.95 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $1.95 Typical High $2.00 | Professional | None | $1.86 | $1.95 | $2.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.88 | Professional | None | $1.86 | $1.86 | $2.88 |
Cigna Setting Facility Modifier None Typical Low $2.51 Median $3.31 Typical High $5.75 | Facility | None | $2.51 | $3.31 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.40 | Professional | None | $1.86 | $1.86 | $2.40 |
DeanCare Setting Facility Modifier None Typical Low $1.00 Median $1.35 Typical High $2.88 | Facility | None | $1.00 | $1.35 | $2.88 |
DeanCare Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $3.47 | Professional | None | $2.04 | $2.04 | $3.47 |
Medica Setting Facility Modifier None Typical Low $1.00 Median $1.70 Typical High $3.55 | Facility | None | $1.00 | $1.70 | $3.55 |
Medica Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $2.29 | Professional | None | $1.70 | $1.70 | $2.29 |
Network Health Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Facility | None | $0.85 | $0.85 | $0.85 |
Network Health Setting Professional Modifier None Typical Low $1.70 Median $2.19 Typical High $2.19 | Professional | None | $1.70 | $2.19 | $2.19 |
Prevea360 Setting Facility Modifier None Typical Low $1.00 Median $1.35 Typical High $2.88 | Facility | None | $1.00 | $1.35 | $2.88 |
Prevea360 Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Quartz Setting Professional Modifier None Typical Low $1.58 Median $2.51 Typical High $4.27 | Professional | None | $1.58 | $2.51 | $4.27 |
Quartz Setting Facility Modifier None Typical Low $2.51 Median $5.75 Typical High $5.75 | Facility | None | $2.51 | $5.75 | $5.75 |
Quartz Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Security Health Setting Professional Modifier None Typical Low $1.23 Median $2.04 Typical High $2.57 | Professional | None | $1.23 | $2.04 | $2.57 |
United Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $2.24 | Professional | None | $1.66 | $1.66 | $2.24 |
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 $0.93 Median $0.98 Typical High $1.00 | Professional | 52 · Reduced service | $0.93 | $0.98 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.39 Typical High $0.40 | Professional | 53 · Discontinued | $0.37 | $0.39 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.20 |
Where Wisconsin sits
Rates are fairly even across states for this service. 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· 41st of 51
$1.86
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.