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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $39.81 | Professional | None | $33.88 | $39.81 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $52.48 Typical High $79.43 | Facility | None | $47.86 | $52.48 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $47.86 | Professional | None | $44.67 | $44.67 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $147.91 Typical High $223.87 | Facility | None | $131.83 | $147.91 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $54.95 Typical High $67.61 | Professional | None | $19.95 | $54.95 | $67.61 |
DeanCare Setting Facility Modifier None Typical Low $33.88 Median $46.77 Typical High $48.98 | Facility | None | $33.88 | $46.77 | $48.98 |
DeanCare Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $97.72 | Professional | None | $51.29 | $97.72 | $97.72 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $46.77 Typical High $64.57 | Facility | None | $33.88 | $46.77 | $64.57 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $23.44 Typical High $263.03 | Professional | None | $20.42 | $23.44 | $263.03 |
Network Health Setting Professional Modifier None Typical Low $35.48 Median $44.67 Typical High $67.61 | Professional | None | $35.48 | $44.67 | $67.61 |
Prevea360 Setting Facility Modifier None Typical Low $33.88 Median $46.77 Typical High $48.98 | Facility | None | $33.88 | $46.77 | $48.98 |
Quartz Setting Professional Modifier None Typical Low $40.74 Median $51.29 Typical High $104.71 | Professional | None | $40.74 | $51.29 | $104.71 |
Quartz Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Security Health Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $18.62 | Professional | None | $15.85 | $15.85 | $18.62 |
The Alliance Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $102.33 | Professional | None | $52.48 | $57.54 | $102.33 |
United Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
United Setting Professional Modifier None Typical Low $10.96 Median $21.88 Typical High $35.48 | Professional | None | $10.96 | $21.88 | $35.48 |
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 $17.38 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $17.38 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $6.92 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $5.25 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.47 | $3.98 | $3.98 |
Where Wisconsin sits
The same service costs 3.2 times more in Montana than in Indiana. 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· 10th of 51
$39.81
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.