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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $288.40 Typical High $831.76 | Professional | None | $123.03 | $288.40 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $389.05 Typical High $467.74 | Facility | None | $199.53 | $389.05 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | None | $125.89 | $125.89 | $181.97 |
DeanCare Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $46.77 | Facility | None | $38.02 | $38.02 | $46.77 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $46.77 Typical High $79.43 | Facility | None | $38.02 | $46.77 | $79.43 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $177.83 | Professional | None | $38.90 | $38.90 | $177.83 |
Prevea360 Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $46.77 | Facility | None | $38.02 | $38.02 | $46.77 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $346.74 | Professional | None | $141.25 | $194.98 | $346.74 |
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 $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Security Health Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $331.13 | Professional | None | $154.88 | $257.04 | $331.13 |
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 $19.05 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
Where Wisconsin sits
The same service costs 4.8 times more in North Dakota than in Hawaii. 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· 3rd of 51
$135
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.