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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $281.84 | Professional | None | $70.79 | $70.79 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $316.23 | Professional | None | $194.98 | $199.53 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $389.05 | Facility | None | $154.88 | $213.80 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $125.89 | Professional | None | $64.57 | $125.89 | $125.89 |
DeanCare Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $147.91 | Facility | None | $67.61 | $67.61 | $147.91 |
DeanCare Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $177.83 | Facility | None | $66.07 | $66.07 | $177.83 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $776.25 | Professional | None | $66.07 | $66.07 | $776.25 |
Network Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Network Health Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $128.82 | Professional | None | $52.48 | $79.43 | $128.82 |
Prevea360 Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $147.91 | Facility | None | $67.61 | $67.61 | $147.91 |
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 $91.20 Median $93.33 Typical High $112.20 | Professional | None | $91.20 | $93.33 | $112.20 |
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 $35.48 Median $35.48 Typical High $141.25 | Professional | 52 · Reduced service | $35.48 | $35.48 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $56.23 | Professional | 53 · Discontinued | $14.13 | $14.13 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $42.66 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $28.18 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $28.18 |
Where Wisconsin sits
The same service costs 2.6 times more in Wyoming than in Washington, DC. 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· 12th 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.