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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $31.62 Typical High $54.95 | Professional | None | $30.90 | $31.62 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $199.53 | Professional | None | $29.51 | $51.29 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $199.53 Typical High $389.05 | Facility | None | $60.26 | $199.53 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $125.89 Typical High $199.53 | Professional | None | $25.12 | $125.89 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $66.07 | Facility | None | $30.20 | $30.20 | $66.07 |
DeanCare Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $75.86 | Facility | None | $30.90 | $30.90 | $75.86 |
Medica Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $134.90 | Professional | None | $30.90 | $30.90 | $134.90 |
Network Health Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Network Health Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $36.31 | Professional | None | $31.62 | $33.88 | $36.31 |
Prevea360 Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $66.07 | Facility | None | $30.20 | $30.20 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $354.81 | Professional | None | $123.03 | $194.98 | $354.81 |
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 $40.74 Median $41.69 Typical High $50.12 | Professional | None | $40.74 | $41.69 | $50.12 |
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 $15.49 Median $15.85 Typical High $27.54 | Professional | 52 · Reduced service | $15.49 | $15.85 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $10.96 | Professional | 53 · Discontinued | $6.31 | $6.31 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $8.32 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.16 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.09 | $3.16 | $5.50 |
Where Wisconsin sits
The same service costs 4.2 times more in Wyoming than in Pennsylvania. 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· 31st of 51
$69.18
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.