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 $128.82 Median $128.82 Typical High $269.15 | Professional | None | $128.82 | $128.82 | $269.15 |
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 $354.81 Typical High $489.78 | Facility | None | $199.53 | $354.81 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $275.42 | Professional | None | $125.89 | $125.89 | $275.42 |
DeanCare Setting Facility Modifier None Typical Low $128.82 Median $162.18 Typical High $162.18 | Facility | None | $128.82 | $162.18 | $162.18 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $162.18 Typical High $162.18 | Facility | None | $128.82 | $162.18 | $162.18 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $223.87 | Professional | None | $162.18 | $162.18 | $223.87 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $162.18 Typical High $162.18 | Facility | None | $128.82 | $162.18 | $162.18 |
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 $218.78 Median $218.78 Typical High $269.15 | Professional | None | $218.78 | $218.78 | $269.15 |
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 $64.57 Median $64.57 Typical High $134.90 | Professional | 52 · Reduced service | $64.57 | $64.57 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $54.95 | Professional | 53 · Discontinued | $25.70 | $25.70 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $40.74 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $26.92 |
Where Wisconsin sits
The same service costs 2.3 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· 4th of 51
$162
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.