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 $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $2,951.21 Typical High $2,951.21 | Professional | None | $758.58 | $2,951.21 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $630.96 Typical High $1,174.90 | Professional | None | $331.13 | $630.96 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $1,288.25 Typical High $1,737.80 | Facility | None | $199.53 | $1,288.25 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $676.08 | Professional | None | $125.89 | $125.89 | $676.08 |
DeanCare Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $2,951.21 | Facility | None | $524.81 | $524.81 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $1,348.96 | Facility | None | $524.81 | $524.81 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $5,011.87 | Professional | None | $3,235.94 | $3,235.94 | $5,011.87 |
Network Health Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Prevea360 Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $2,951.21 | Facility | None | $524.81 | $524.81 | $2,951.21 |
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 $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 $707.95 Median $707.95 Typical High $870.96 | Professional | None | $707.95 | $707.95 | $870.96 |
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 $380.19 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $380.19 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $151.36 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $114.82 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $75.86 | $295.12 | $295.12 |
Where Wisconsin sits
The same service costs 26.9 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· 11th of 51
$631
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.