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 $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $102.33 | Professional | None | $23.99 | $23.99 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $34.67 Median $38.02 Typical High $56.23 | Facility | None | $34.67 | $38.02 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $38.90 | Professional | None | $31.62 | $31.62 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $107.15 Typical High $158.49 | Facility | None | $93.33 | $107.15 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $27.54 Typical High $57.54 | Professional | None | $14.13 | $27.54 | $57.54 |
DeanCare Setting Facility Modifier None Typical Low $19.50 Median $33.88 Typical High $35.48 | Facility | None | $19.50 | $33.88 | $35.48 |
DeanCare Setting Professional Modifier None Typical Low $30.90 Median $33.88 Typical High $37.15 | Professional | None | $30.90 | $33.88 | $37.15 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $33.88 Typical High $67.61 | Facility | None | $19.50 | $33.88 | $67.61 |
Medica Setting Professional Modifier None Typical Low $15.49 Median $22.39 Typical High $257.04 | Professional | None | $15.49 | $22.39 | $257.04 |
Network Health Setting Professional Modifier None Typical Low $31.62 Median $44.67 Typical High $85.11 | Professional | None | $31.62 | $44.67 | $85.11 |
Prevea360 Setting Facility Modifier None Typical Low $19.50 Median $33.88 Typical High $35.48 | Facility | None | $19.50 | $33.88 | $35.48 |
Prevea360 Setting Professional Modifier None Typical Low $21.38 Median $33.88 Typical High $33.88 | Professional | None | $21.38 | $33.88 | $33.88 |
Quartz Setting Professional Modifier None Typical Low $33.11 Median $51.29 Typical High $75.86 | Professional | None | $33.11 | $51.29 | $75.86 |
Quartz Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
United Setting Professional Modifier None Typical Low $11.22 Median $16.98 Typical High $30.90 | Professional | None | $11.22 | $16.98 | $30.90 |
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 $12.02 Median $12.02 Typical High $51.29 | Professional | 52 · Reduced service | $12.02 | $12.02 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $20.42 | Professional | 53 · Discontinued | $4.79 | $4.79 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $18.20 Typical High $77.62 | Professional | 54 · Surgery only | $18.20 | $18.20 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $15.49 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $10.23 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $10.23 |
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
$31.62
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.