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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | None | $38.02 | $40.74 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $54.95 Typical High $81.28 | Facility | None | $48.98 | $54.95 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | None | $45.71 | $45.71 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $154.88 Typical High $229.09 | Facility | None | $134.90 | $154.88 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $54.95 Typical High $70.79 | Professional | None | $22.39 | $54.95 | $70.79 |
DeanCare Setting Facility Modifier None Typical Low $38.02 Median $48.98 Typical High $51.29 | Facility | None | $38.02 | $48.98 | $51.29 |
DeanCare Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $97.72 | Professional | None | $69.18 | $97.72 | $97.72 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $48.98 Typical High $72.44 | Facility | None | $38.02 | $48.98 | $72.44 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $23.99 Typical High $288.40 | Professional | None | $21.88 | $23.99 | $288.40 |
Network Health Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Network Health Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $70.79 | Professional | None | $36.31 | $45.71 | $70.79 |
Prevea360 Setting Facility Modifier None Typical Low $38.02 Median $48.98 Typical High $51.29 | Facility | None | $38.02 | $48.98 | $51.29 |
Quartz Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $114.82 | Professional | None | $44.67 | $56.23 | $114.82 |
Quartz Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
The Alliance Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $112.20 | Professional | None | $58.88 | $64.57 | $112.20 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $10.96 Median $22.39 Typical High $36.31 | Professional | None | $10.96 | $22.39 | $36.31 |
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 $19.05 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $19.05 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $7.76 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $5.75 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.80 | $4.07 | $4.07 |
Where Wisconsin sits
The same service costs 3.3 times more in Montana than in Missouri. 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· 13th of 51
$40.74
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.