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 $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $53.70 | Professional | None | $16.98 | $16.98 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.99 Median $26.30 Typical High $39.81 | Facility | None | $23.99 | $26.30 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $26.92 | Professional | None | $22.39 | $22.39 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $74.13 Typical High $112.20 | Facility | None | $66.07 | $74.13 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $19.05 Typical High $39.81 | Professional | None | $9.77 | $19.05 | $39.81 |
DeanCare Setting Facility Modifier None Typical Low $13.80 Median $23.44 Typical High $24.55 | Facility | None | $13.80 | $23.44 | $24.55 |
DeanCare Setting Professional Modifier None Typical Low $21.38 Median $23.44 Typical High $25.70 | Professional | None | $21.38 | $23.44 | $25.70 |
Medica Setting Facility Modifier None Typical Low $13.80 Median $23.44 Typical High $47.86 | Facility | None | $13.80 | $23.44 | $47.86 |
Medica Setting Professional Modifier None Typical Low $10.96 Median $15.85 Typical High $309.03 | Professional | None | $10.96 | $15.85 | $309.03 |
Network Health Setting Professional Modifier None Typical Low $22.39 Median $31.62 Typical High $58.88 | Professional | None | $22.39 | $31.62 | $58.88 |
Prevea360 Setting Facility Modifier None Typical Low $13.80 Median $23.44 Typical High $24.55 | Facility | None | $13.80 | $23.44 | $24.55 |
Prevea360 Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $25.12 | Professional | None | $23.44 | $23.44 | $25.12 |
Quartz Setting Professional Modifier None Typical Low $22.91 Median $36.31 Typical High $52.48 | Professional | None | $22.91 | $36.31 | $52.48 |
Quartz Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
United Setting Professional Modifier None Typical Low $7.94 Median $11.75 Typical High $21.88 | Professional | None | $7.94 | $11.75 | $21.88 |
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 $8.51 Median $8.51 Typical High $26.92 | Professional | 52 · Reduced service | $8.51 | $8.51 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $10.72 | Professional | 53 · Discontinued | $3.39 | $3.39 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.88 Median $12.88 Typical High $40.74 | Professional | 54 · Surgery only | $12.88 | $12.88 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $8.13 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $5.37 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $5.37 |
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· 10th of 51
$22.39
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.