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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $363.08 | Professional | None | $107.15 | $107.15 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $165.96 Typical High $245.47 | Facility | None | $151.36 | $165.96 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | None | $141.25 | $141.25 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $467.74 Typical High $691.83 | Facility | None | $407.38 | $467.74 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $251.19 | Professional | None | $61.66 | $120.23 | $251.19 |
DeanCare Setting Facility Modifier None Typical Low $85.11 Median $147.91 Typical High $154.88 | Facility | None | $85.11 | $147.91 | $154.88 |
DeanCare Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | None | $134.90 | $147.91 | $162.18 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $147.91 Typical High $302.00 | Facility | None | $85.11 | $147.91 | $302.00 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $1,288.25 | Professional | None | $67.61 | $97.72 | $1,288.25 |
Network Health Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $371.54 | Professional | None | $138.04 | $194.98 | $371.54 |
Prevea360 Setting Facility Modifier None Typical Low $85.11 Median $147.91 Typical High $154.88 | Facility | None | $85.11 | $147.91 | $154.88 |
Prevea360 Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $147.91 | Professional | None | $107.15 | $147.91 | $147.91 |
Quartz Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $331.13 | Professional | None | $144.54 | $223.87 | $331.13 |
Quartz Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $138.04 | Professional | None | $48.98 | $74.13 | $138.04 |
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 $52.48 Median $52.48 Typical High $181.97 | Professional | 52 · Reduced service | $52.48 | $52.48 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $72.44 | Professional | 53 · Discontinued | $21.38 | $21.38 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $269.15 | Professional | 54 · Surgery only | $79.43 | $79.43 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $54.95 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $36.31 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $36.31 |
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· 8th of 51
$141
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.