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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | None | $123.03 | $147.91 | $147.91 |
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 $169.82 Median $354.81 Typical High $467.74 | Facility | None | $169.82 | $354.81 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $181.97 | Professional | None | $109.65 | $109.65 | $181.97 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
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 $144.54 Median $331.13 Typical High $331.13 | Facility | None | $144.54 | $331.13 | $331.13 |
Quartz Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $138.04 Median $173.78 Typical High $331.13 | Professional | None | $138.04 | $173.78 | $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 $61.66 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $61.66 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $24.55 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $14.79 |
Where Wisconsin sits
The same service costs 2.3 times more in North Dakota 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· 4th 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.