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 $0.12 Median $0.12 Typical High $0.27 | Facility | None | $0.12 | $0.12 | $0.27 |
Aetna Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $3.02 | Professional | None | $0.12 | $0.12 | $3.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.06 Typical High $1.51 | Professional | 52 · Reduced service | $0.06 | $0.06 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.60 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.45 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $6.76 | Professional | None | $0.13 | $0.13 | $6.76 |
CareSource Setting Professional Modifier None Typical Low $1.70 Median $1.78 Typical High $2.63 | Professional | None | $1.70 | $1.78 | $2.63 |
Cigna Setting Facility Modifier None Typical Low $0.20 Median $0.89 Typical High $1.20 | Facility | None | $0.20 | $0.89 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $3.02 | Professional | None | $0.13 | $0.13 | $3.02 |
DeanCare Setting Facility Modifier None Typical Low $0.12 Median $2.00 Typical High $4.27 | Facility | None | $0.12 | $2.00 | $4.27 |
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 $0.12 Median $2.34 Typical High $4.68 | Facility | None | $0.12 | $2.34 | $4.68 |
Medica Setting Professional Modifier None Typical Low $0.10 Median $0.13 Typical High $61.66 | Professional | None | $0.10 | $0.13 | $61.66 |
Network Health Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
Network Health Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | None | $2.45 | $2.45 | $2.95 |
Prevea360 Setting Facility Modifier None Typical Low $0.12 Median $2.00 Typical High $4.27 | Facility | None | $0.12 | $2.00 | $4.27 |
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 $2.24 Median $3.80 Typical High $5.37 | Professional | None | $2.24 | $3.80 | $5.37 |
Quartz Setting Facility Modifier None Typical Low $0.17 Median $0.40 Typical High $0.40 | Facility | None | $0.17 | $0.40 | $0.40 |
Quartz Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
Security Health Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $5.62 | Professional | None | $3.02 | $3.02 | $5.62 |
United Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.17 | Professional | None | $0.13 | $0.13 | $0.17 |
1 more rate 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 56 · Pre-op care only Typical Low $0.20 Median $0.30 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.20 | $0.30 | $0.50 |
Where Wisconsin sits
The same service costs 32.4 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· 34th of 51
$0.13
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.