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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $72.44 Typical High $128.82 | Professional | None | $70.79 | $72.44 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $194.98 | Professional | None | $50.12 | $50.12 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $213.80 Typical High $389.05 | Facility | None | $165.96 | $213.80 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $199.53 | Professional | None | $69.18 | $125.89 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $151.36 | Facility | None | $69.18 | $69.18 | $151.36 |
DeanCare Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $151.36 Typical High $302.00 | Facility | None | $69.18 | $151.36 | $302.00 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $302.00 | Professional | None | $69.18 | $69.18 | $302.00 |
Network Health Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Network Health Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $81.28 | Professional | None | $70.79 | $75.86 | $81.28 |
Prevea360 Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $151.36 | Facility | None | $69.18 | $69.18 | $151.36 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $323.59 | Professional | None | $141.25 | $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 $93.33 Median $95.50 Typical High $114.82 | Professional | None | $93.33 | $95.50 | $114.82 |
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 $36.31 Typical High $64.57 | Professional | 52 · Reduced service | $35.48 | $36.31 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.45 Typical High $25.70 | Professional | 53 · Discontinued | $14.13 | $14.45 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $19.50 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.24 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.08 | $7.24 | $12.88 |
Where Wisconsin sits
The same service costs 2.7 times more in North Dakota than in North Carolina. 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· 25th of 51
$93.33
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.