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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,318.26 | Professional | None | $512.86 | $512.86 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,949.84 Typical High $5,128.61 | Professional | None | $891.25 | $1,949.84 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $954.99 Typical High $1,288.25 | Facility | None | $199.53 | $954.99 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $501.19 | Professional | None | $125.89 | $125.89 | $501.19 |
DeanCare Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $1,071.52 | Facility | None | $489.78 | $489.78 | $1,071.52 |
DeanCare Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $1,071.52 | Facility | None | $489.78 | $489.78 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $2,398.83 | Professional | None | $489.78 | $489.78 | $2,398.83 |
Network Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Network Health Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $588.84 | Professional | None | $239.88 | $363.08 | $588.84 |
Prevea360 Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $1,071.52 | Facility | None | $489.78 | $489.78 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $380.19 | Professional | None | $141.25 | $194.98 | $380.19 |
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 $660.69 Median $676.08 Typical High $812.83 | Professional | None | $660.69 | $676.08 | $812.83 |
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 $251.19 Median $257.04 Typical High $660.69 | Professional | 52 · Reduced service | $251.19 | $257.04 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $263.03 | Professional | 53 · Discontinued | $102.33 | $102.33 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $199.53 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $131.83 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $131.83 |
Where Wisconsin sits
The same service costs 7.1 times more in Wyoming 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· 5th of 51
$513
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.