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 $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.63 Typical High $48.98 | Professional | None | $2.57 | $2.63 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $23.44 | Professional | None | $12.59 | $12.59 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $199.53 Typical High $389.05 | Facility | None | $22.39 | $199.53 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $125.89 Typical High $199.53 | Professional | None | $9.33 | $125.89 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $5.75 | Facility | None | $2.51 | $2.51 | $5.75 |
DeanCare Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Medica Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $75.86 | Facility | None | $2.45 | $2.45 | $75.86 |
Medica Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $5,370.32 | Professional | None | $2.45 | $2.45 | $5,370.32 |
Network Health Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
Network Health Setting Professional Modifier None Typical Low $10.47 Median $11.22 Typical High $12.02 | Professional | None | $10.47 | $11.22 | $12.02 |
Prevea360 Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $5.75 | Facility | None | $2.51 | $2.51 | $5.75 |
Quartz Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $323.59 | Professional | None | $123.03 | $194.98 | $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 $3.39 Median $3.47 Typical High $4.17 | Professional | None | $3.39 | $3.47 | $4.17 |
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 $1.29 Median $1.32 Typical High $24.55 | Professional | 52 · Reduced service | $1.29 | $1.32 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $9.77 | Professional | 53 · Discontinued | $0.52 | $0.52 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.39 Typical High $7.41 | Professional | 55 · Aftercare only | $0.39 | $0.39 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $4.90 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $4.90 |
Where Wisconsin sits
The same service costs 50.1 times more in Massachusetts than in Indiana. 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· 37th of 51
$12.59
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.