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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $95.50 | Facility | None | $57.54 | $63.10 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | None | $53.70 | $53.70 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $181.97 Typical High $269.15 | Facility | None | $158.49 | $181.97 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $60.26 Typical High $83.18 | Professional | None | $25.70 | $60.26 | $83.18 |
DeanCare Setting Facility Modifier None Typical Low $43.65 Median $56.23 Typical High $60.26 | Facility | None | $43.65 | $56.23 | $60.26 |
DeanCare Setting Professional Modifier None Typical Low $61.66 Median $97.72 Typical High $97.72 | Professional | None | $61.66 | $97.72 | $97.72 |
Medica Setting Facility Modifier None Typical Low $43.65 Median $56.23 Typical High $83.18 | Facility | None | $43.65 | $56.23 | $83.18 |
Medica Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $331.13 | Professional | None | $25.70 | $28.18 | $331.13 |
Network Health Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $83.18 | Professional | None | $42.66 | $53.70 | $83.18 |
Prevea360 Setting Facility Modifier None Typical Low $43.65 Median $56.23 Typical High $60.26 | Facility | None | $43.65 | $56.23 | $60.26 |
Quartz Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $131.83 | Professional | None | $51.29 | $66.07 | $131.83 |
Quartz Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
The Alliance Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $128.82 | Professional | None | $67.61 | $74.13 | $128.82 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $10.96 Median $26.30 Typical High $42.66 | Professional | None | $10.96 | $26.30 | $42.66 |
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 $23.99 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $4.79 |
Where Wisconsin sits
The same service costs 3.0 times more in Hawaii 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· 14th of 51
$47.86
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.