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 $27.54 Median $27.54 Typical High $61.66 | Facility | None | $27.54 | $27.54 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $269.15 | Professional | None | $27.54 | $27.54 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $53.70 Typical High $60.26 | Facility | None | $50.12 | $53.70 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $45.71 | Professional | None | $26.92 | $29.51 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $41.69 Typical High $81.28 | Facility | None | $28.18 | $41.69 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $33.88 Typical High $51.29 | Professional | None | $26.92 | $33.88 | $51.29 |
DeanCare Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $58.88 | Facility | None | $26.92 | $26.92 | $58.88 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $93.33 | Facility | None | $25.12 | $25.12 | $93.33 |
Medica Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None | $25.12 | $25.12 | $34.67 |
Network Health Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $47.86 | Facility | None | $33.11 | $33.11 | $47.86 |
Prevea360 Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $58.88 | Facility | None | $26.92 | $26.92 | $58.88 |
Quartz Setting Professional Modifier None Typical Low $25.70 Median $42.66 Typical High $70.79 | Professional | None | $25.70 | $42.66 | $70.79 |
Quartz Setting Facility Modifier None Typical Low $35.48 Median $81.28 Typical High $81.28 | Facility | None | $35.48 | $81.28 | $81.28 |
Quartz Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Security Health Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $66.07 | Professional | None | $36.31 | $37.15 | $66.07 |
United Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
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 $13.80 Median $13.80 Typical High $134.90 | Professional | 52 · Reduced service | $13.80 | $13.80 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $54.95 | Professional | 53 · Discontinued | $5.50 | $5.50 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $40.74 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $26.92 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $26.92 |
Where Wisconsin sits
The same service costs 2.9 times more in Wyoming than in Minnesota. 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· 21st of 51
$29.51
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.