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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $239.88 | Professional | None | $93.33 | $93.33 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $933.25 | Professional | None | $144.54 | $245.47 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $263.03 Typical High $389.05 | Facility | None | $199.53 | $263.03 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $223.87 | Professional | None | $97.72 | $125.89 | $223.87 |
DeanCare Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $194.98 | Facility | None | $87.10 | $87.10 | $194.98 |
DeanCare Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $177.83 | Facility | None | $81.28 | $81.28 | $177.83 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $562.34 | Professional | None | $81.28 | $81.28 | $562.34 |
Network Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Network Health Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $112.20 | Professional | None | $97.72 | $104.71 | $112.20 |
Prevea360 Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $194.98 | Facility | None | $87.10 | $87.10 | $194.98 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $398.11 | Professional | None | $141.25 | $218.78 | $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 $117.49 Median $120.23 Typical High $144.54 | Professional | None | $117.49 | $120.23 | $144.54 |
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 $45.71 Median $45.71 Typical High $120.23 | Professional | 52 · Reduced service | $45.71 | $45.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $47.86 | Professional | 53 · Discontinued | $18.62 | $18.62 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $36.31 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $23.99 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $23.99 |
Where Wisconsin sits
The same service costs 1.9 times more in Alaska than in New York. 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
$145
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.