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 $16.60 Median $16.60 Typical High $31.62 | Facility | None | $16.60 | $16.60 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $77.62 | Professional | None | $16.60 | $16.60 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $27.54 Typical High $30.20 | Facility | None | $25.12 | $27.54 | $30.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $17.78 Typical High $20.42 | Professional | None | $16.22 | $17.78 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $32.36 Typical High $48.98 | Facility | None | $25.12 | $32.36 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $21.38 Typical High $28.18 | Professional | None | $16.22 | $21.38 | $28.18 |
DeanCare Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $61.66 | Facility | None | $27.54 | $27.54 | $61.66 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $120.23 | Facility | None | $26.30 | $26.30 | $120.23 |
Medica Setting Professional Modifier None Typical Low $26.30 Median $29.51 Typical High $38.90 | Professional | None | $26.30 | $29.51 | $38.90 |
Network Health Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $34.67 | Facility | None | $21.88 | $21.88 | $34.67 |
Prevea360 Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $61.66 | Facility | None | $27.54 | $27.54 | $61.66 |
Quartz Setting Professional Modifier None Typical Low $11.22 Median $21.88 Typical High $70.79 | Professional | None | $11.22 | $21.88 | $70.79 |
Quartz Setting Facility Modifier None Typical Low $26.92 Median $48.98 Typical High $48.98 | Facility | None | $26.92 | $48.98 | $48.98 |
Quartz Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Security Health Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $26.92 | Professional | None | $21.88 | $21.88 | $26.92 |
United Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $19.95 | Professional | None | $13.80 | $15.14 | $19.95 |
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 $8.32 Median $8.32 Typical High $138.04 | Professional | 52 · Reduced service | $8.32 | $8.32 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $56.23 | Professional | 53 · Discontinued | $3.31 | $3.31 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $41.69 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.66 Typical High $28.18 | Professional | 56 · Pre-op care only | $1.66 | $1.66 | $28.18 |
Where Wisconsin sits
The same service costs 5.9 times more in Wyoming 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· 9th of 51
$19.50
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.