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 $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $2,187.76 Typical High $2,187.76 | Professional | None | $512.86 | $2,187.76 | $2,187.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $851.14 | Professional | None | $173.78 | $275.42 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $426.58 Typical High $575.44 | Facility | None | $199.53 | $426.58 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Professional | None | $125.89 | $125.89 | $223.87 |
DeanCare Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $4,570.88 | Facility | None | $2,089.30 | $2,089.30 | $4,570.88 |
Medica Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $4,897.79 | Facility | None | $2,238.72 | $2,238.72 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $11,748.98 | Professional | None | $2,238.72 | $2,238.72 | $11,748.98 |
Network Health Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Prevea360 Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $4,570.88 | Facility | None | $2,089.30 | $2,089.30 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $407.38 | Professional | None | $141.25 | $194.98 | $407.38 |
Quartz Setting Facility Modifier None Typical Low $169.82 Median $389.05 Typical High $389.05 | Facility | None | $169.82 | $389.05 | $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 $2,818.38 Median $2,818.38 Typical High $3,467.37 | Professional | None | $2,818.38 | $2,818.38 | $3,467.37 |
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 $257.04 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $257.04 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $102.33 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $75.86 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $51.29 | $218.78 | $218.78 |
Where Wisconsin sits
The same service costs 24.0 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· 23rd of 51
$275
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.