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 $134.90 Median $134.90 Typical High $275.42 | Facility | None | $134.90 | $134.90 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $1,071.52 | Professional | None | $134.90 | $134.90 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $239.88 Typical High $269.15 | Facility | None | $223.87 | $239.88 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $194.98 | Professional | None | $131.83 | $144.54 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $218.78 Typical High $407.38 | Facility | None | $31.62 | $218.78 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $245.47 | Professional | None | $114.82 | $138.04 | $245.47 |
DeanCare Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $67.61 | Facility | None | $30.20 | $30.20 | $67.61 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $61.66 | Facility | None | $28.18 | $28.18 | $61.66 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $40.74 | Professional | None | $28.18 | $30.90 | $40.74 |
Network Health Setting Facility Modifier None Typical Low $95.50 Median $371.54 Typical High $371.54 | Facility | None | $95.50 | $371.54 | $371.54 |
Prevea360 Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $67.61 | Facility | None | $30.20 | $30.20 | $67.61 |
Quartz Setting Professional Modifier None Typical Low $40.74 Median $128.82 Typical High $190.55 | Professional | None | $40.74 | $128.82 | $190.55 |
Quartz Setting Facility Modifier None Typical Low $218.78 Median $407.38 Typical High $407.38 | Facility | None | $218.78 | $407.38 | $407.38 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Security Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $218.78 | Professional | None | $177.83 | $177.83 | $218.78 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $177.83 | Professional | None | $120.23 | $131.83 | $177.83 |
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 $67.61 Median $67.61 Typical High $537.03 | Professional | 52 · Reduced service | $67.61 | $67.61 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $213.80 | Professional | 53 · Discontinued | $26.92 | $26.92 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $158.49 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $107.15 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $107.15 |
Where Wisconsin sits
The same service costs 8.7 times more in Texas than in Kansas. 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
$135
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.