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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $346.74 | Professional | None | $102.33 | $102.33 | $346.74 |
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 $263.03 Typical High $389.05 | Facility | None | $199.53 | $263.03 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $131.83 | Professional | None | $95.50 | $125.89 | $131.83 |
DeanCare Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $213.80 | Facility | None | $97.72 | $97.72 | $213.80 |
DeanCare Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $239.88 | Facility | None | $100.00 | $100.00 | $239.88 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $1,071.52 | Professional | None | $100.00 | $100.00 | $1,071.52 |
Network Health Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $158.49 | Professional | None | $66.07 | $97.72 | $158.49 |
Prevea360 Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $213.80 | Facility | None | $97.72 | $97.72 | $213.80 |
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 $131.83 Median $134.90 Typical High $162.18 | Professional | None | $131.83 | $134.90 | $162.18 |
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 $51.29 Median $51.29 Typical High $173.78 | Professional | 52 · Reduced service | $51.29 | $51.29 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $70.79 | Professional | 53 · Discontinued | $20.42 | $20.42 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $52.48 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $34.67 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $34.67 |
Where Wisconsin sits
The same service costs 2.5 times more in Wyoming 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· 5th of 51
$132
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.