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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $107.15 | Professional | None | $93.33 | $95.50 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $162.18 | Professional | None | $100.00 | $154.88 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $199.53 Typical High $389.05 | Facility | None | $165.96 | $199.53 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $199.53 | Professional | None | $69.18 | $125.89 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $199.53 | Facility | None | $91.20 | $91.20 | $199.53 |
DeanCare Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $147.91 | Facility | None | $67.61 | $67.61 | $147.91 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $302.00 | Professional | None | $67.61 | $67.61 | $302.00 |
Network Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Network Health Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $81.28 | Professional | None | $70.79 | $75.86 | $81.28 |
Prevea360 Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $199.53 | Facility | None | $91.20 | $91.20 | $199.53 |
Quartz Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $323.59 | Professional | None | $134.90 | $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 $123.03 Median $125.89 Typical High $151.36 | Professional | None | $123.03 | $125.89 | $151.36 |
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 $46.77 Median $47.86 Typical High $53.70 | Professional | 52 · Reduced service | $46.77 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $21.38 | Professional | 53 · Discontinued | $19.05 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.45 Typical High $16.22 | Professional | 55 · Aftercare only | $14.13 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.55 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.33 | $9.55 | $10.72 |
Where Wisconsin sits
The same service costs 2.1 times more in Alaska than in Montana. 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· 20th 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.