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 $43.65 | Professional | None | $30.90 | $30.90 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $151.36 | Professional | None | $46.77 | $67.61 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $43.65 Typical High $100.00 | Facility | None | $29.51 | $43.65 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $33.11 Typical High $33.11 | Professional | None | $12.30 | $33.11 | $33.11 |
DeanCare Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $21.88 | Facility | None | $10.00 | $10.00 | $21.88 |
DeanCare Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Medica Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $75.86 | Facility | None | $10.72 | $10.72 | $75.86 |
Medica Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $75.86 | Professional | None | $10.72 | $10.72 | $75.86 |
Network Health Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Network Health Setting Professional Modifier None Typical Low $8.32 Median $12.59 Typical High $20.42 | Professional | None | $8.32 | $12.59 | $20.42 |
Prevea360 Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $21.88 | Facility | None | $10.00 | $10.00 | $21.88 |
Quartz Setting Professional Modifier None Typical Low $11.22 Median $18.20 Typical High $100.00 | Professional | None | $11.22 | $18.20 | $100.00 |
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 $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Security Health Setting Professional Modifier None Typical Low $13.49 Median $13.80 Typical High $16.60 | Professional | None | $13.49 | $13.80 | $16.60 |
United Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
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 $21.88 | Professional | 52 · Reduced service | $15.49 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $8.71 | Professional | 53 · Discontinued | $6.31 | $6.31 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $6.61 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $4.37 |
Where Wisconsin sits
The same service costs 5.6 times more in Alaska 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· 2nd of 51
$39.81
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.