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 $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $38.02 | Professional | None | $5.75 | $5.75 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.32 Median $9.12 Typical High $13.49 | Facility | None | $8.32 | $9.12 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $9.33 | Professional | None | $7.59 | $7.59 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $25.70 Typical High $38.02 | Facility | None | $22.39 | $25.70 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $6.61 Typical High $13.80 | Professional | None | $3.39 | $6.61 | $13.80 |
DeanCare Setting Facility Modifier None Typical Low $4.68 Median $8.13 Typical High $8.51 | Facility | None | $4.68 | $8.13 | $8.51 |
DeanCare Setting Professional Modifier None Typical Low $7.41 Median $46.77 Typical High $53.70 | Professional | None | $7.41 | $46.77 | $53.70 |
Medica Setting Facility Modifier None Typical Low $4.68 Median $8.13 Typical High $16.60 | Facility | None | $4.68 | $8.13 | $16.60 |
Medica Setting Professional Modifier None Typical Low $3.72 Median $5.37 Typical High $107.15 | Professional | None | $3.72 | $5.37 | $107.15 |
Network Health Setting Professional Modifier None Typical Low $7.59 Median $10.72 Typical High $20.42 | Professional | None | $7.59 | $10.72 | $20.42 |
Prevea360 Setting Facility Modifier None Typical Low $4.68 Median $8.13 Typical High $8.51 | Facility | None | $4.68 | $8.13 | $8.51 |
Prevea360 Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.12 | Professional | None | $8.13 | $8.13 | $9.12 |
Quartz Setting Professional Modifier None Typical Low $7.76 Median $12.30 Typical High $17.78 | Professional | None | $7.76 | $12.30 | $17.78 |
Quartz Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Security Health Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $17.78 | Professional | None | $15.14 | $15.14 | $17.78 |
United Setting Professional Modifier None Typical Low $2.69 Median $4.07 Typical High $7.59 | Professional | None | $2.69 | $4.07 | $7.59 |
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 $2.88 Median $2.88 Typical High $19.05 | Professional | 52 · Reduced service | $2.88 | $2.88 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.15 Typical High $7.59 | Professional | 53 · Discontinued | $1.15 | $1.15 | $7.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.37 Median $4.37 Typical High $28.18 | Professional | 54 · Surgery only | $4.37 | $4.37 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $5.75 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.58 Typical High $3.80 | Professional | 56 · Pre-op care only | $0.58 | $0.58 | $3.80 |
Where Wisconsin sits
The same service costs 3.2 times more in Rhode Island 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· 11th of 51
$7.59
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.