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 $0.45 Median $0.45 Typical High $1.00 | Facility | None | $0.45 | $0.45 | $1.00 |
Aetna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $3.98 | Professional | None | $0.45 | $0.45 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.47 Median $0.55 Typical High $2.29 | Professional | None | $0.47 | $0.55 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $0.76 Median $1.82 Typical High $2.40 | Facility | None | $0.76 | $1.82 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $1.00 | Professional | None | $0.48 | $0.48 | $1.00 |
DeanCare Setting Facility Modifier None Typical Low $0.45 Median $0.66 Typical High $1.41 | Facility | None | $0.45 | $0.66 | $1.41 |
DeanCare Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Medica Setting Facility Modifier None Typical Low $0.45 Median $0.66 Typical High $1.41 | Facility | None | $0.45 | $0.66 | $1.41 |
Medica Setting Professional Modifier None Typical Low $0.47 Median $0.59 Typical High $218.78 | Professional | None | $0.47 | $0.59 | $218.78 |
Network Health Setting Facility Modifier None Typical Low $0.69 Median $0.69 Typical High $0.69 | Facility | None | $0.69 | $0.69 | $0.69 |
Network Health Setting Professional Modifier None Typical Low $0.81 Median $0.81 Typical High $1.00 | Professional | None | $0.81 | $0.81 | $1.00 |
Prevea360 Setting Facility Modifier None Typical Low $0.45 Median $0.66 Typical High $1.41 | Facility | None | $0.45 | $0.66 | $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 $0.74 Median $1.26 Typical High $1.82 | Professional | None | $0.74 | $1.26 | $1.82 |
Quartz Setting Facility Modifier None Typical Low $0.65 Median $1.45 Typical High $1.45 | Facility | None | $0.65 | $1.45 | $1.45 |
Quartz Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Security Health Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.51 | Professional | None | $0.79 | $0.79 | $1.51 |
United Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.62 | Professional | None | $0.47 | $0.47 | $0.62 |
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 $0.23 Median $0.23 Typical High $2.00 | Professional | 52 · Reduced service | $0.23 | $0.23 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.79 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.60 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.40 |
Where Wisconsin sits
The same service costs 2.3 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· 38th of 51
$0.48
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.