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 $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,548.82 | Professional | None | $467.74 | $467.74 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,445.44 Typical High $3,388.44 | Professional | None | $851.14 | $1,445.44 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $1,174.90 Typical High $1,584.89 | Facility | None | $199.53 | $1,174.90 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $616.60 | Professional | None | $125.89 | $125.89 | $616.60 |
DeanCare Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $1,000.00 | Facility | None | $446.68 | $446.68 | $1,000.00 |
DeanCare Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $1,380.38 | Facility | None | $478.63 | $478.63 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $2,691.53 | Professional | None | $478.63 | $478.63 | $2,691.53 |
Prevea360 Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $1,000.00 | Facility | None | $446.68 | $446.68 | $1,000.00 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $524.81 | Professional | None | $141.25 | $194.98 | $524.81 |
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 $602.56 Median $616.60 Typical High $741.31 | Professional | None | $602.56 | $616.60 | $741.31 |
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 $234.42 Median $234.42 Typical High $758.58 | Professional | 52 · Reduced service | $234.42 | $234.42 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $309.03 | Professional | 53 · Discontinued | $93.33 | $93.33 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $229.09 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $154.88 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $154.88 |
Where Wisconsin sits
The same service costs 10.0 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· 4th of 51
$661
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.