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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | None | $54.95 | $66.07 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $89.13 Typical High $134.90 | Facility | None | $81.28 | $89.13 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | None | $75.86 | $75.86 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $251.19 Typical High $371.54 | Facility | None | $218.78 | $251.19 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $60.26 Typical High $114.82 | Professional | None | $28.84 | $60.26 | $114.82 |
DeanCare Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $83.18 | Facility | None | $50.12 | $79.43 | $83.18 |
DeanCare Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $117.49 | Professional | None | $87.10 | $97.72 | $117.49 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $95.50 | Facility | None | $50.12 | $79.43 | $95.50 |
Medica Setting Professional Modifier None Typical Low $29.51 Median $39.81 Typical High $371.54 | Professional | None | $29.51 | $39.81 | $371.54 |
Network Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Network Health Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $114.82 | Professional | None | $58.88 | $75.86 | $114.82 |
Prevea360 Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $83.18 | Facility | None | $50.12 | $79.43 | $83.18 |
Quartz Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $151.36 | Professional | None | $58.88 | $77.62 | $151.36 |
Quartz Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
The Alliance Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $147.91 | Professional | None | $75.86 | $85.11 | $147.91 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $10.96 Median $37.15 Typical High $60.26 | Professional | None | $10.96 | $37.15 | $60.26 |
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 $27.54 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $27.54 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $10.96 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $8.32 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.50 | $6.61 | $6.61 |
Where Wisconsin sits
The same service costs 2.8 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· 5th of 51
$66.07
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.