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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $758.58 | Professional | None | $123.03 | $123.03 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $977.24 | Professional | None | $323.59 | $416.87 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $954.99 Typical High $1,258.93 | Facility | None | $199.53 | $954.99 | $1,258.93 |
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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $457.09 | Facility | None | $354.81 | $354.81 | $457.09 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,819.70 | Professional | None | $478.63 | $478.63 | $1,819.70 |
Prevea360 Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
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 $478.63 Median $478.63 Typical High $588.84 | Professional | None | $478.63 | $478.63 | $588.84 |
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 $61.66 Median $61.66 Typical High $380.19 | Professional | 52 · Reduced service | $61.66 | $61.66 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $151.36 | Professional | 53 · Discontinued | $24.55 | $24.55 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $114.82 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $75.86 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $75.86 |
Where Wisconsin sits
The same service costs 4.1 times more in Alaska 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· 7th of 51
$363
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.