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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $794.33 | Professional | None | $83.18 | $83.18 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,698.24 Typical High $4,365.16 | Professional | None | $776.25 | $1,698.24 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $223.87 Typical High $389.05 | Facility | None | $194.98 | $223.87 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $199.53 | Professional | None | $81.28 | $125.89 | $199.53 |
DeanCare Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $177.83 | Facility | None | $79.43 | $79.43 | $177.83 |
DeanCare Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $676.08 | Facility | None | $79.43 | $79.43 | $676.08 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $2,754.23 | Professional | None | $79.43 | $79.43 | $2,754.23 |
Network Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Network Health Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,071.52 | Professional | None | $436.52 | $660.69 | $1,071.52 |
Prevea360 Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $177.83 | Facility | None | $79.43 | $79.43 | $177.83 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $398.11 | Professional | None | $141.25 | $194.98 | $398.11 |
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 $107.15 Median $109.65 Typical High $131.83 | Professional | None | $107.15 | $109.65 | $131.83 |
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 $41.69 Median $41.69 Typical High $398.11 | Professional | 52 · Reduced service | $41.69 | $41.69 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.98 Typical High $158.49 | Professional | 53 · Discontinued | $16.60 | $16.98 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $120.23 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $79.43 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $79.43 |
Where Wisconsin sits
The same service costs 7.2 times more in Hawaii 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· 4th of 51
$145
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.