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 $51.29 Median $53.70 Typical High $53.70 | Professional | None | $51.29 | $53.70 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $72.44 Typical High $107.15 | Facility | None | $66.07 | $72.44 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | None | $60.26 | $60.26 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $204.17 Typical High $302.00 | Facility | None | $177.83 | $204.17 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $60.26 Typical High $93.33 | Professional | None | $28.84 | $60.26 | $93.33 |
DeanCare Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $67.61 | Facility | None | $48.98 | $64.57 | $67.61 |
DeanCare Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $131.83 | Professional | None | $70.79 | $97.72 | $131.83 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $93.33 | Facility | None | $48.98 | $64.57 | $93.33 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $371.54 | Professional | None | $28.84 | $31.62 | $371.54 |
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 $48.98 Median $64.57 Typical High $67.61 | Facility | None | $48.98 | $64.57 | $67.61 |
Quartz Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $147.91 | Professional | None | $58.88 | $74.13 | $147.91 |
Quartz Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
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 $25.70 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $25.70 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.23 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.76 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.13 | $5.37 | $5.37 |
Where Wisconsin sits
The same service costs 2.6 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
$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.