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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $61.66 | Professional | None | $17.78 | $17.78 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $28.18 Typical High $41.69 | Facility | None | $25.70 | $28.18 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $28.84 | Professional | None | $23.44 | $23.44 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $79.43 Typical High $117.49 | Facility | None | $69.18 | $79.43 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $20.42 Typical High $42.66 | Professional | None | $10.47 | $20.42 | $42.66 |
DeanCare Setting Facility Modifier None Typical Low $14.45 Median $25.12 Typical High $26.30 | Facility | None | $14.45 | $25.12 | $26.30 |
DeanCare Setting Professional Modifier None Typical Low $22.91 Median $93.33 Typical High $107.15 | Professional | None | $22.91 | $93.33 | $107.15 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $25.12 Typical High $51.29 | Facility | None | $14.45 | $25.12 | $51.29 |
Medica Setting Professional Modifier None Typical Low $11.48 Median $16.60 Typical High $199.53 | Professional | None | $11.48 | $16.60 | $199.53 |
Network Health Setting Professional Modifier None Typical Low $23.44 Median $33.11 Typical High $63.10 | Professional | None | $23.44 | $33.11 | $63.10 |
Prevea360 Setting Facility Modifier None Typical Low $14.45 Median $25.12 Typical High $26.30 | Facility | None | $14.45 | $25.12 | $26.30 |
Prevea360 Setting Professional Modifier None Typical Low $16.22 Median $25.12 Typical High $25.12 | Professional | None | $16.22 | $25.12 | $25.12 |
Quartz Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $56.23 | Professional | None | $24.55 | $38.02 | $56.23 |
Quartz Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.59 Typical High $22.91 | Professional | None | $8.32 | $12.59 | $22.91 |
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 $8.91 Median $8.91 Typical High $30.20 | Professional | 52 · Reduced service | $8.91 | $8.91 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $12.30 | Professional | 53 · Discontinued | $3.63 | $3.63 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.49 Median $13.49 Typical High $45.71 | Professional | 54 · Surgery only | $13.49 | $13.49 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $9.12 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $6.17 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $6.17 |
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
$23.44
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.