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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $512.86 | Professional | None | $93.33 | $93.33 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $562.34 | Professional | None | $85.11 | $144.54 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $257.04 Typical High $389.05 | Facility | None | $199.53 | $257.04 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $199.53 | Professional | None | $93.33 | $125.89 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $194.98 | Facility | None | $89.13 | $89.13 | $194.98 |
DeanCare Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $223.87 | Facility | None | $93.33 | $93.33 | $223.87 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $436.52 | Professional | None | $93.33 | $93.33 | $436.52 |
Network Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Network Health Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $147.91 | Professional | None | $61.66 | $91.20 | $147.91 |
Prevea360 Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $194.98 | Facility | None | $89.13 | $89.13 | $194.98 |
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 $120.23 Median $123.03 Typical High $147.91 | Professional | None | $120.23 | $123.03 | $147.91 |
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 $46.77 Typical High $257.04 | Professional | 52 · Reduced service | $46.77 | $46.77 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $102.33 | Professional | 53 · Discontinued | $18.62 | $18.62 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $75.86 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $51.29 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $51.29 |
Where Wisconsin sits
The same service costs 2.1 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· 14th 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.