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 $69.18 Median $69.18 Typical High $181.97 | Facility | None | $69.18 | $69.18 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $407.38 | Professional | None | $69.18 | $69.18 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $158.49 Typical High $177.83 | Facility | None | $147.91 | $158.49 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $114.82 | Professional | None | $67.61 | $74.13 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $147.91 Typical High $275.42 | Facility | None | $102.33 | $147.91 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $181.97 | Professional | None | $67.61 | $102.33 | $181.97 |
DeanCare Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $331.13 | Facility | None | $100.00 | $100.00 | $331.13 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $371.54 | Facility | None | $104.71 | $104.71 | $371.54 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $151.36 | Professional | None | $104.71 | $114.82 | $151.36 |
Network Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $144.54 | Facility | None | $128.82 | $128.82 | $144.54 |
Prevea360 Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $331.13 | Facility | None | $100.00 | $100.00 | $331.13 |
Quartz Setting Professional Modifier None Typical Low $60.26 Median $125.89 Typical High $257.04 | Professional | None | $60.26 | $125.89 | $257.04 |
Quartz Setting Facility Modifier None Typical Low $109.65 Median $204.17 Typical High $204.17 | Facility | None | $109.65 | $204.17 | $204.17 |
Quartz Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Security Health Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $380.19 | Professional | None | $91.20 | $93.33 | $380.19 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $117.49 | Professional | None | $79.43 | $89.13 | $117.49 |
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 $34.67 Median $34.67 Typical High $426.58 | Professional | 52 · Reduced service | $34.67 | $34.67 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $169.82 | Professional | 53 · Discontinued | $13.80 | $13.80 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $125.89 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $85.11 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $85.11 |
Where Wisconsin sits
The same service costs 2.7 times more in South Carolina than in Georgia. 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· 17th of 51
$89.13
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.