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 $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
Aetna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $44.67 | Professional | None | $1.41 | $1.41 | $44.67 |
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 $1.20 Median $1.20 Typical High $1.20 | Facility | None | $1.20 | $1.20 | $1.20 |
Medica Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $100.00 | Facility | None | $1.20 | $1.20 | $100.00 |
Prevea360 Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Facility | None | $1.20 | $1.20 | $1.20 |
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 $138.04 Median $173.78 Typical High $331.13 | Professional | None | $138.04 | $173.78 | $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 $0.71 Median $0.71 Typical High $22.39 | Professional | 52 · Reduced service | $0.71 | $0.71 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $8.91 | Professional | 53 · Discontinued | $0.28 | $0.28 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $6.76 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $4.47 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $4.47 |
Where Wisconsin sits
The same service costs 14.8 times more in North Dakota than in New Jersey. 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
$148
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.