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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $77.62 | Professional | None | $70.79 | $75.86 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $467.74 | Professional | None | $54.95 | $87.10 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $199.53 Typical High $389.05 | Facility | None | $91.20 | $199.53 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $125.89 Typical High $199.53 | Professional | None | $38.02 | $125.89 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $25.12 Median $70.79 Typical High $158.49 | Facility | None | $25.12 | $70.79 | $158.49 |
DeanCare Setting Professional Modifier None Typical Low $29.51 Median $32.36 Typical High $32.36 | Professional | None | $29.51 | $32.36 | $32.36 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $70.79 Typical High $158.49 | Facility | None | $25.12 | $70.79 | $158.49 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $398.11 | Professional | None | $70.79 | $70.79 | $398.11 |
Network Health Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Prevea360 Setting Facility Modifier None Typical Low $25.12 Median $70.79 Typical High $158.49 | Facility | None | $25.12 | $70.79 | $158.49 |
Quartz Setting Professional Modifier None Typical Low $81.28 Median $169.82 Typical High $323.59 | Professional | None | $81.28 | $169.82 | $323.59 |
Quartz Setting Facility Modifier None Typical Low $204.17 Median $288.40 Typical High $389.05 | Facility | None | $204.17 | $288.40 | $389.05 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Security Health Setting Professional Modifier None Typical Low $28.84 Median $95.50 Typical High $117.49 | Professional | None | $28.84 | $95.50 | $117.49 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
4 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 $35.48 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $35.48 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.14 Typical High $15.49 | Professional | 53 · Discontinued | $14.45 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $11.75 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.59 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.08 | $7.59 | $7.76 |
Where Wisconsin sits
The same service costs 2.0 times more in North Dakota than in Maryland. 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· 32nd of 51
$87.10
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.