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 $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $74.13 | Professional | None | $12.02 | $14.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $21.88 Typical High $33.11 | Facility | None | $19.95 | $21.88 | $33.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $22.39 | Professional | None | $18.62 | $18.62 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $63.10 Typical High $93.33 | Facility | None | $54.95 | $63.10 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $16.22 Typical High $33.11 | Professional | None | $8.13 | $16.22 | $33.11 |
DeanCare Setting Facility Modifier None Typical Low $11.48 Median $19.50 Typical High $20.89 | Facility | None | $11.48 | $19.50 | $20.89 |
DeanCare Setting Professional Modifier None Typical Low $17.78 Median $81.28 Typical High $93.33 | Professional | None | $17.78 | $81.28 | $93.33 |
Medica Setting Facility Modifier None Typical Low $11.48 Median $19.50 Typical High $39.81 | Facility | None | $11.48 | $19.50 | $39.81 |
Medica Setting Professional Modifier None Typical Low $9.12 Median $13.18 Typical High $158.49 | Professional | None | $9.12 | $13.18 | $158.49 |
Network Health Setting Professional Modifier None Typical Low $18.62 Median $26.30 Typical High $48.98 | Professional | None | $18.62 | $26.30 | $48.98 |
Prevea360 Setting Facility Modifier None Typical Low $11.48 Median $19.50 Typical High $20.89 | Facility | None | $11.48 | $19.50 | $20.89 |
Prevea360 Setting Professional Modifier None Typical Low $13.18 Median $19.50 Typical High $19.50 | Professional | None | $13.18 | $19.50 | $19.50 |
Quartz Setting Professional Modifier None Typical Low $19.05 Median $30.20 Typical High $44.67 | Professional | None | $19.05 | $30.20 | $44.67 |
Quartz Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Security Health Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $25.70 | Professional | None | $21.88 | $21.88 | $25.70 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.77 Typical High $18.20 | Professional | None | $6.61 | $9.77 | $18.20 |
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 $7.08 Median $7.08 Typical High $37.15 | Professional | 52 · Reduced service | $7.08 | $7.08 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $14.79 | Professional | 53 · Discontinued | $2.82 | $2.82 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $10.72 Typical High $54.95 | Professional | 54 · Surgery only | $10.72 | $10.72 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $11.22 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $7.41 |
Where Wisconsin sits
The same service costs 2.8 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· 10th of 51
$18.62
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.