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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $117.49 | Professional | None | $53.70 | $53.70 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $83.18 Typical High $123.03 | Facility | None | $75.86 | $83.18 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $85.11 | Professional | None | $69.18 | $69.18 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $234.42 Typical High $346.74 | Facility | None | $204.17 | $234.42 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $60.26 Typical High $125.89 | Professional | None | $30.90 | $60.26 | $125.89 |
DeanCare Setting Facility Modifier None Typical Low $42.66 Median $74.13 Typical High $77.62 | Facility | None | $42.66 | $74.13 | $77.62 |
DeanCare Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $81.28 | Professional | None | $67.61 | $74.13 | $81.28 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $74.13 Typical High $151.36 | Facility | None | $42.66 | $74.13 | $151.36 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $48.98 Typical High $645.65 | Professional | None | $33.88 | $48.98 | $645.65 |
Network Health Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $186.21 | Professional | None | $69.18 | $97.72 | $186.21 |
Prevea360 Setting Facility Modifier None Typical Low $42.66 Median $74.13 Typical High $77.62 | Facility | None | $42.66 | $74.13 | $77.62 |
Prevea360 Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $74.13 | Professional | None | $53.70 | $74.13 | $74.13 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $165.96 | Professional | None | $72.44 | $112.20 | $165.96 |
Quartz Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $67.61 | Professional | None | $24.55 | $37.15 | $67.61 |
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 $26.30 Median $26.30 Typical High $58.88 | Professional | 52 · Reduced service | $26.30 | $26.30 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $23.44 | Professional | 53 · Discontinued | $10.72 | $10.72 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $39.81 Typical High $87.10 | Professional | 54 · Surgery only | $39.81 | $39.81 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $17.38 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $11.75 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $11.75 |
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
$69.18
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.