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 $562.34 | Professional | None | $128.82 | $128.82 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $346.74 Typical High $912.01 | Professional | None | $162.18 | $346.74 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $407.38 | Facility | None | $199.53 | $316.23 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $199.53 | Professional | None | $125.89 | $125.89 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $275.42 | Facility | None | $123.03 | $123.03 | $275.42 |
DeanCare Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $275.42 | Facility | None | $125.89 | $125.89 | $275.42 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $3,090.30 | Professional | None | $125.89 | $125.89 | $3,090.30 |
Network Health Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Network Health Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $218.78 | Professional | None | $89.13 | $134.90 | $218.78 |
Prevea360 Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $275.42 | Facility | None | $123.03 | $123.03 | $275.42 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $354.81 | Professional | None | $141.25 | $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 $165.96 Median $169.82 Typical High $204.17 | Professional | None | $165.96 | $169.82 | $204.17 |
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 $281.84 | Professional | 52 · Reduced service | $64.57 | $64.57 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $112.20 | Professional | 53 · Discontinued | $25.70 | $25.70 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $85.11 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $56.23 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $56.23 |
Where Wisconsin sits
The same service costs 1.9 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· 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.