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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $125.89 | Professional | None | $104.71 | $107.15 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $616.60 | Professional | None | $95.50 | $169.82 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $389.05 | Facility | None | $199.53 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $199.53 | Professional | None | $104.71 | $125.89 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $223.87 | Facility | None | $102.33 | $102.33 | $223.87 |
DeanCare Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $229.09 | Facility | None | $100.00 | $100.00 | $229.09 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $512.86 | Professional | None | $100.00 | $100.00 | $512.86 |
Network Health Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Network Health Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $138.04 | Professional | None | $120.23 | $128.82 | $138.04 |
Prevea360 Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $223.87 | Facility | None | $102.33 | $102.33 | $223.87 |
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 $138.04 Median $141.25 Typical High $169.82 | Professional | None | $138.04 | $141.25 | $169.82 |
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 $52.48 Median $53.70 Typical High $63.10 | Professional | 52 · Reduced service | $52.48 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | 53 · Discontinued | $21.38 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $18.62 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $12.59 |
Where Wisconsin sits
The same service costs 2.4 times more in Wyoming 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· 23rd of 51
$126
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.