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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $194.98 | Professional | None | $30.90 | $30.90 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $186.21 | Professional | None | $41.69 | $77.62 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $72.44 Typical High $100.00 | Facility | None | $50.12 | $72.44 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $35.48 | Professional | None | $30.90 | $32.36 | $35.48 |
DeanCare Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $58.88 | Facility | None | $26.92 | $26.92 | $58.88 |
Medica Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $60.26 | Facility | None | $27.54 | $27.54 | $60.26 |
Medica Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $37.15 | Professional | None | $27.54 | $27.54 | $37.15 |
Network Health Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Prevea360 Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $58.88 | Facility | None | $26.92 | $26.92 | $58.88 |
Quartz Setting Professional Modifier None Typical Low $35.48 Median $63.10 Typical High $87.10 | Professional | None | $35.48 | $63.10 | $87.10 |
Quartz Setting Facility Modifier None Typical Low $43.65 Median $100.00 Typical High $100.00 | Facility | None | $43.65 | $100.00 | $100.00 |
Quartz Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Security Health Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $44.67 | Professional | None | $36.31 | $36.31 | $44.67 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $43.65 | Professional | None | $32.36 | $32.36 | $43.65 |
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 $15.49 Median $15.49 Typical High $97.72 | Professional | 52 · Reduced service | $15.49 | $15.49 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $38.90 | Professional | 53 · Discontinued | $6.17 | $6.17 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $29.51 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $19.50 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $19.50 |
Where Wisconsin sits
The same service costs 1.9 times more in Alaska than in Connecticut. 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· 3rd of 51
$41.69
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.