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 $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $724.44 | Professional | None | $575.44 | $575.44 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $1,047.13 Typical High $3,090.30 | Professional | None | $616.60 | $1,047.13 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $602.56 Typical High $812.83 | Facility | None | $199.53 | $602.56 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $316.23 | Professional | None | $125.89 | $125.89 | $316.23 |
DeanCare Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $1,230.27 | Facility | None | $549.54 | $549.54 | $1,230.27 |
DeanCare Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $1,071.52 | Facility | None | $194.98 | $194.98 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $4,786.30 | Professional | None | $194.98 | $194.98 | $4,786.30 |
Network Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Network Health Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $436.52 | Professional | None | $177.83 | $269.15 | $436.52 |
Prevea360 Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $1,230.27 | Facility | None | $549.54 | $549.54 | $1,230.27 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $630.96 | Professional | None | $141.25 | $194.98 | $630.96 |
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 $741.31 Median $758.58 Typical High $912.01 | Professional | None | $741.31 | $758.58 | $912.01 |
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 $288.40 Median $288.40 Typical High $363.08 | Professional | 52 · Reduced service | $288.40 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $109.65 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $72.44 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $72.44 |
Where Wisconsin sits
The same service costs 9.1 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· 4th of 51
$575
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.