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 $0.36 Median $0.36 Typical High $0.79 | Facility | None | $0.36 | $0.36 | $0.79 |
Aetna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $2.00 | Professional | None | $0.36 | $0.36 | $2.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.65 Median $0.71 Typical High $0.78 | Facility | None | $0.65 | $0.71 | $0.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.35 Median $0.38 Typical High $0.44 | Professional | None | $0.35 | $0.38 | $0.44 |
Cigna Setting Facility Modifier None Typical Low $0.54 Median $0.89 Typical High $1.07 | Facility | None | $0.54 | $0.89 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.47 Typical High $0.65 | Professional | None | $0.35 | $0.47 | $0.65 |
DeanCare Setting Facility Modifier None Typical Low $0.46 Median $0.46 Typical High $0.71 | Facility | None | $0.46 | $0.46 | $0.71 |
DeanCare Setting Professional Modifier None Typical Low $0.69 Median $0.69 Typical High $0.69 | Professional | None | $0.69 | $0.69 | $0.69 |
Medica Setting Facility Modifier None Typical Low $0.37 Median $0.37 Typical High $0.71 | Facility | None | $0.37 | $0.37 | $0.71 |
Medica Setting Professional Modifier None Typical Low $0.37 Median $0.41 Typical High $0.54 | Professional | None | $0.37 | $0.41 | $0.54 |
Network Health Setting Facility Modifier None Typical Low $0.34 Median $0.34 Typical High $0.34 | Facility | None | $0.34 | $0.34 | $0.34 |
Prevea360 Setting Facility Modifier None Typical Low $0.46 Median $0.46 Typical High $0.71 | Facility | None | $0.46 | $0.46 | $0.71 |
Prevea360 Setting Professional Modifier None Typical Low $0.69 Median $0.69 Typical High $0.69 | Professional | None | $0.69 | $0.69 | $0.69 |
Quartz Setting Professional Modifier None Typical Low $0.30 Median $0.56 Typical High $1.26 | Professional | None | $0.30 | $0.56 | $1.26 |
Quartz Setting Facility Modifier None Typical Low $0.58 Median $1.07 Typical High $1.07 | Facility | None | $0.58 | $1.07 | $1.07 |
Quartz Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Security Health Setting Professional Modifier None Typical Low $0.47 Median $0.48 Typical High $0.68 | Professional | None | $0.47 | $0.48 | $0.68 |
United Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Facility | None | $0.35 | $0.35 | $0.35 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.39 Typical High $0.51 | Professional | None | $0.35 | $0.39 | $0.51 |
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 $0.18 Median $0.18 Typical High $1.00 | Professional | 52 · Reduced service | $0.18 | $0.18 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.40 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.30 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.20 |
Where Wisconsin sits
The same service costs 3.0 times more in Texas than in North Dakota. 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· 16th of 51
$0.41
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.