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 $5.25 Median $5.25 Typical High $5.25 | Facility | None | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $30.20 | Professional | None | $5.25 | $5.25 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.41 Median $8.13 Typical High $12.02 | Facility | None | $7.41 | $8.13 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.32 | Professional | None | $6.92 | $6.92 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $22.39 Typical High $33.88 | Facility | None | $19.95 | $22.39 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $5.89 Typical High $12.30 | Professional | None | $3.02 | $5.89 | $12.30 |
DeanCare Setting Facility Modifier None Typical Low $4.17 Median $7.24 Typical High $7.59 | Facility | None | $4.17 | $7.24 | $7.59 |
DeanCare Setting Professional Modifier None Typical Low $6.61 Median $7.24 Typical High $7.94 | Professional | None | $6.61 | $7.24 | $7.94 |
Medica Setting Facility Modifier None Typical Low $4.17 Median $7.24 Typical High $14.79 | Facility | None | $4.17 | $7.24 | $14.79 |
Medica Setting Professional Modifier None Typical Low $3.31 Median $4.79 Typical High $63.10 | Professional | None | $3.31 | $4.79 | $63.10 |
Network Health Setting Professional Modifier None Typical Low $6.76 Median $9.55 Typical High $18.20 | Professional | None | $6.76 | $9.55 | $18.20 |
Prevea360 Setting Facility Modifier None Typical Low $4.17 Median $7.24 Typical High $7.59 | Facility | None | $4.17 | $7.24 | $7.59 |
Prevea360 Setting Professional Modifier None Typical Low $5.37 Median $7.24 Typical High $7.24 | Professional | None | $5.37 | $7.24 | $7.24 |
Quartz Setting Professional Modifier None Typical Low $6.61 Median $10.96 Typical High $15.14 | Professional | None | $6.61 | $10.96 | $15.14 |
Quartz Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
The Alliance Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.63 Typical High $6.76 | Professional | None | $2.40 | $3.63 | $6.76 |
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 $2.57 Median $2.57 Typical High $15.14 | Professional | 52 · Reduced service | $2.57 | $2.57 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.05 Typical High $6.03 | Professional | 53 · Discontinued | $1.05 | $1.05 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.89 Median $3.89 Typical High $22.39 | Professional | 54 · Surgery only | $3.89 | $3.89 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.78 Typical High $4.47 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $3.02 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $3.02 |
Where Wisconsin sits
The same service costs 2.7 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· 9th of 51
$6.92
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.