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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $128.82 Typical High $128.82 | Professional | None | $7.94 | $128.82 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $288.40 Typical High $831.76 | Professional | None | $123.03 | $288.40 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $346.74 Typical High $407.38 | Facility | None | $199.53 | $346.74 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | None | $125.89 | $125.89 | $181.97 |
DeanCare Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $138.04 Typical High $4,073.80 | Facility | None | $100.00 | $138.04 | $4,073.80 |
Prevea360 Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $380.19 | Professional | None | $141.25 | $194.98 | $380.19 |
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 $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Security Health Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $331.13 | Professional | None | $154.88 | $257.04 | $331.13 |
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 $3.98 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $3.98 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $1.58 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $12.88 |
Where Wisconsin sits
The same service costs 5.9 times more in North Dakota 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· 3rd of 51
$151
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.