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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $398.11 | Professional | None | $144.54 | $144.54 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $323.59 Typical High $1,000.00 | Professional | None | $151.36 | $323.59 | $1,000.00 |
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 $208.93 | Professional | None | $125.89 | $125.89 | $208.93 |
DeanCare Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $302.00 | Facility | None | $138.04 | $138.04 | $302.00 |
DeanCare Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $239.88 | Facility | None | $109.65 | $109.65 | $239.88 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $1,023.29 | Professional | None | $109.65 | $109.65 | $1,023.29 |
Network Health Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Network Health Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $275.42 | Professional | None | $239.88 | $257.04 | $275.42 |
Prevea360 Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $302.00 | Facility | None | $138.04 | $138.04 | $302.00 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $398.11 | Professional | None | $141.25 | $194.98 | $398.11 |
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 $186.21 Median $190.55 Typical High $229.09 | Professional | None | $186.21 | $190.55 | $229.09 |
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 $72.44 Median $72.44 Typical High $199.53 | Professional | 52 · Reduced service | $72.44 | $72.44 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $79.43 | Professional | 53 · Discontinued | $28.84 | $28.84 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $58.88 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $39.81 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $39.81 |
Where Wisconsin sits
The same service costs 2.6 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· 5th of 51
$155
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.