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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $812.83 | Professional | None | $478.63 | $489.78 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $213.80 Typical High $5,248.07 | Professional | None | $104.71 | $213.80 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $1,230.27 Typical High $1,621.81 | Facility | None | $199.53 | $1,230.27 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $645.65 | Professional | None | $125.89 | $125.89 | $645.65 |
DeanCare Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $1,023.29 | Facility | None | $457.09 | $457.09 | $1,023.29 |
DeanCare Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $1,412.54 | Facility | None | $331.13 | $331.13 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $3,630.78 | Professional | None | $331.13 | $331.13 | $3,630.78 |
Network Health Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Network Health Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $616.60 | Professional | None | $537.03 | $575.44 | $616.60 |
Prevea360 Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $1,023.29 | Facility | None | $457.09 | $457.09 | $1,023.29 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $323.59 | Professional | None | $141.25 | $194.98 | $323.59 |
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 $616.60 Median $630.96 Typical High $758.58 | Professional | None | $616.60 | $630.96 | $758.58 |
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 $239.88 Median $239.88 Typical High $407.38 | Professional | 52 · Reduced service | $239.88 | $239.88 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $97.72 Typical High $162.18 | Professional | 53 · Discontinued | $95.50 | $97.72 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $123.03 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $48.98 Typical High $81.28 | Professional | 56 · Pre-op care only | $47.86 | $48.98 | $81.28 |
Where Wisconsin sits
The same service costs 12.0 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· 24th of 51
$251
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.