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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $398.11 | Professional | None | $72.44 | $74.13 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $676.08 | Professional | None | $169.82 | $288.40 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $204.17 Typical High $389.05 | Facility | None | $181.97 | $204.17 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $223.87 | Professional | None | $74.13 | $125.89 | $223.87 |
DeanCare Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $154.88 | Facility | None | $70.79 | $70.79 | $154.88 |
DeanCare Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $302.00 | Facility | None | $70.79 | $70.79 | $302.00 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $457.09 | Professional | None | $70.79 | $70.79 | $457.09 |
Network Health Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Network Health Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $85.11 | Professional | None | $74.13 | $81.28 | $85.11 |
Prevea360 Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $154.88 | Facility | None | $70.79 | $70.79 | $154.88 |
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 $95.50 Median $97.72 Typical High $117.49 | Professional | None | $95.50 | $97.72 | $117.49 |
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 $37.15 Median $37.15 Typical High $199.53 | Professional | 52 · Reduced service | $37.15 | $37.15 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $79.43 | Professional | 53 · Discontinued | $14.79 | $14.79 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $58.88 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $39.81 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $39.81 |
Where Wisconsin sits
The same service costs 3.6 times more in Wyoming than in Indiana. 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· 2nd of 51
$151
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.