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 $141.25 Median $141.25 Typical High $309.03 | Facility | None | $141.25 | $141.25 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $1,288.25 | Professional | None | $141.25 | $141.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $295.12 | Facility | None | $245.47 | $269.15 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $173.78 | Professional | None | $138.04 | $151.36 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $416.87 | Facility | None | $134.90 | $223.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $245.47 | Professional | None | $138.04 | $173.78 | $245.47 |
DeanCare Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $288.40 | Facility | None | $131.83 | $131.83 | $288.40 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $676.08 | Facility | None | $131.83 | $131.83 | $676.08 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $194.98 | Professional | None | $131.83 | $147.91 | $194.98 |
Network Health Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $154.88 | Facility | None | $66.07 | $66.07 | $154.88 |
Prevea360 Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $288.40 | Facility | None | $131.83 | $131.83 | $288.40 |
Quartz Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $537.03 | Professional | None | $134.90 | $213.80 | $537.03 |
Quartz Setting Facility Modifier None Typical Low $223.87 Median $416.87 Typical High $416.87 | Facility | None | $223.87 | $416.87 | $416.87 |
Quartz Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Security Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $229.09 | Professional | None | $186.21 | $186.21 | $229.09 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $194.98 | Professional | None | $131.83 | $147.91 | $194.98 |
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 $70.79 Median $70.79 Typical High $645.65 | Professional | 52 · Reduced service | $70.79 | $70.79 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $257.04 | Professional | 53 · Discontinued | $28.18 | $28.18 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $190.55 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $128.82 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $128.82 |
Where Wisconsin sits
The same service costs 5.5 times more in Texas than in Oregon. 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· 15th of 51
$151
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.