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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $53.70 Typical High $53.70 | Professional | None | $46.77 | $53.70 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $70.79 Typical High $107.15 | Facility | None | $64.57 | $70.79 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | None | $60.26 | $60.26 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $199.53 Typical High $302.00 | Facility | None | $177.83 | $199.53 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $60.26 Typical High $93.33 | Professional | None | $26.92 | $60.26 | $93.33 |
DeanCare Setting Facility Modifier None Typical Low $45.71 Median $63.10 Typical High $67.61 | Facility | None | $45.71 | $63.10 | $67.61 |
DeanCare Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $107.15 | Professional | None | $69.18 | $97.72 | $107.15 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $63.10 Typical High $87.10 | Facility | None | $45.71 | $63.10 | $87.10 |
Medica Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $346.74 | Professional | None | $27.54 | $31.62 | $346.74 |
Network Health Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $93.33 | Professional | None | $47.86 | $60.26 | $93.33 |
Prevea360 Setting Facility Modifier None Typical Low $45.71 Median $63.10 Typical High $67.61 | Facility | None | $45.71 | $63.10 | $67.61 |
Quartz Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $138.04 | Professional | None | $54.95 | $69.18 | $138.04 |
Quartz Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $10.96 Median $29.51 Typical High $47.86 | Professional | None | $10.96 | $29.51 | $47.86 |
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 $23.44 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $23.44 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $9.33 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.08 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.68 | $5.37 | $5.37 |
Where Wisconsin sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 6th of 51
$53.70
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.