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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $85.11 | Professional | None | $33.88 | $33.88 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $52.48 Typical High $79.43 | Facility | None | $47.86 | $52.48 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | None | $44.67 | $44.67 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $147.91 Typical High $223.87 | Facility | None | $131.83 | $147.91 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $38.90 Typical High $79.43 | Professional | None | $19.50 | $38.90 | $79.43 |
DeanCare Setting Facility Modifier None Typical Low $27.54 Median $46.77 Typical High $48.98 | Facility | None | $27.54 | $46.77 | $48.98 |
DeanCare Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $51.29 | Professional | None | $42.66 | $46.77 | $51.29 |
Medica Setting Facility Modifier None Typical Low $27.54 Median $46.77 Typical High $95.50 | Facility | None | $27.54 | $46.77 | $95.50 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $31.62 Typical High $616.60 | Professional | None | $21.88 | $31.62 | $616.60 |
Network Health Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $117.49 | Professional | None | $44.67 | $63.10 | $117.49 |
Prevea360 Setting Facility Modifier None Typical Low $27.54 Median $46.77 Typical High $48.98 | Facility | None | $27.54 | $46.77 | $48.98 |
Prevea360 Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $50.12 | Professional | None | $46.77 | $46.77 | $50.12 |
Quartz Setting Professional Modifier None Typical Low $45.71 Median $72.44 Typical High $104.71 | Professional | None | $45.71 | $72.44 | $104.71 |
Quartz Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $15.85 Median $23.44 Typical High $43.65 | Professional | None | $15.85 | $23.44 | $43.65 |
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 $16.98 Median $16.98 Typical High $42.66 | Professional | 52 · Reduced service | $16.98 | $16.98 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $16.98 | Professional | 53 · Discontinued | $6.76 | $6.76 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $25.70 Typical High $63.10 | Professional | 54 · Surgery only | $25.70 | $25.70 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $12.88 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $8.51 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $8.51 |
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· 9th of 51
$44.67
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.