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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $134.90 | Professional | None | $41.69 | $41.69 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $162.18 Typical High $741.31 | Professional | None | $77.62 | $162.18 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $426.58 | Facility | None | $199.53 | $363.08 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $169.82 | Professional | None | $79.43 | $125.89 | $169.82 |
DeanCare Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $87.10 | Facility | None | $38.90 | $38.90 | $87.10 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $977.24 | Facility | None | $41.69 | $41.69 | $977.24 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $3,981.07 | Professional | None | $41.69 | $41.69 | $3,981.07 |
Network Health Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Prevea360 Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $87.10 | Facility | None | $38.90 | $38.90 | $87.10 |
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 $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 $52.48 Median $53.70 Typical High $64.57 | Professional | None | $52.48 | $53.70 | $64.57 |
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 $20.42 Median $20.42 Typical High $67.61 | Professional | 52 · Reduced service | $20.42 | $20.42 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $26.92 | Professional | 53 · Discontinued | $8.32 | $8.32 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $20.42 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $13.49 |
Where Wisconsin sits
The same service costs 25.1 times more in Wyoming than in Kentucky. 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· 27th 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.