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 $0.08 Median $0.08 Typical High $0.18 | Facility | None | $0.08 | $0.08 | $0.18 |
Aetna Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $10.00 | Professional | None | $0.08 | $0.08 | $10.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.04 Median $0.04 Typical High $5.01 | Professional | 52 · Reduced service | $0.04 | $0.04 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $2.00 | Professional | 53 · Discontinued | $0.02 | $0.02 | $2.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $2.29 | Professional | None | $0.08 | $0.08 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $0.14 Median $0.89 Typical High $1.20 | Facility | None | $0.14 | $0.89 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $1.00 | Professional | None | $0.09 | $0.09 | $1.00 |
DeanCare Setting Facility Modifier None Typical Low $0.04 Median $0.04 Typical High $1.41 | Facility | None | $0.04 | $0.04 | $1.41 |
DeanCare Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.26 | Professional | None | $0.13 | $0.13 | $0.26 |
Medica Setting Facility Modifier None Typical Low $0.04 Median $0.04 Typical High $1.41 | Facility | None | $0.04 | $0.04 | $1.41 |
Medica Setting Professional Modifier None Typical Low $0.08 Median $0.10 Typical High $64.57 | Professional | None | $0.08 | $0.10 | $64.57 |
Network Health Setting Facility Modifier None Typical Low $0.15 Median $0.30 Typical High $0.30 | Facility | None | $0.15 | $0.30 | $0.30 |
Network Health Setting Professional Modifier None Typical Low $0.03 Median $0.81 Typical High $0.81 | Professional | None | $0.03 | $0.81 | $0.81 |
Prevea360 Setting Facility Modifier None Typical Low $0.04 Median $0.04 Typical High $1.41 | Facility | None | $0.04 | $0.04 | $1.41 |
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 $0.72 Median $1.29 Typical High $1.86 | Professional | None | $0.72 | $1.29 | $1.86 |
Quartz Setting Facility Modifier None Typical Low $0.12 Median $0.27 Typical High $0.27 | Facility | None | $0.12 | $0.27 | $0.27 |
Quartz Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | None | $0.09 | $0.09 | $0.09 |
Security Health Setting Professional Modifier None Typical Low $0.02 Median $0.05 Typical High $0.06 | Professional | None | $0.02 | $0.05 | $0.06 |
United Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.11 | Professional | None | $0.08 | $0.08 | $0.11 |
2 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 55 · Aftercare only Typical Low $0.89 Median $1.51 Typical High $2.09 | Professional | 55 · Aftercare only | $0.89 | $1.51 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.60 Median $1.00 Typical High $1.41 | Professional | 56 · Pre-op care only | $0.60 | $1.00 | $1.41 |
Where Wisconsin sits
The same service costs 14.8 times more in Montana than in Hawaii. 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· 9th of 51
$0.09
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.