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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $75.86 | Professional | None | $31.62 | $31.62 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $44.67 Median $48.98 Typical High $74.13 | Facility | None | $44.67 | $48.98 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $50.12 | Professional | None | $41.69 | $41.69 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $138.04 Typical High $208.93 | Facility | None | $123.03 | $138.04 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $35.48 Typical High $74.13 | Professional | None | $18.20 | $35.48 | $74.13 |
DeanCare Setting Facility Modifier None Typical Low $25.70 Median $43.65 Typical High $45.71 | Facility | None | $25.70 | $43.65 | $45.71 |
DeanCare Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $47.86 | Professional | None | $39.81 | $43.65 | $47.86 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $43.65 Typical High $89.13 | Facility | None | $25.70 | $43.65 | $89.13 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $29.51 Typical High $398.11 | Professional | None | $20.42 | $29.51 | $398.11 |
Network Health Setting Professional Modifier None Typical Low $41.69 Median $58.88 Typical High $109.65 | Professional | None | $41.69 | $58.88 | $109.65 |
Prevea360 Setting Facility Modifier None Typical Low $25.70 Median $43.65 Typical High $45.71 | Facility | None | $25.70 | $43.65 | $45.71 |
Prevea360 Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $43.65 | Professional | None | $32.36 | $43.65 | $43.65 |
Quartz Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $97.72 | Professional | None | $42.66 | $67.61 | $97.72 |
Quartz Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Security Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $33.11 | Professional | None | $28.18 | $28.18 | $33.11 |
United Setting Professional Modifier None Typical Low $14.45 Median $21.88 Typical High $40.74 | Professional | None | $14.45 | $21.88 | $40.74 |
5 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 $15.85 Median $15.85 Typical High $38.02 | Professional | 52 · Reduced service | $15.85 | $15.85 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $15.14 | Professional | 53 · Discontinued | $6.31 | $6.31 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $23.44 Typical High $57.54 | Professional | 54 · Surgery only | $23.44 | $23.44 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $11.48 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $7.59 |
Where Wisconsin sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 8th of 51
$41.69
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.