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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $74.13 | Professional | None | $61.66 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $97.72 Typical High $147.91 | Facility | None | $89.13 | $97.72 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | None | $83.18 | $83.18 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $275.42 Typical High $416.87 | Facility | None | $245.47 | $275.42 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $64.57 Typical High $125.89 | Professional | None | $32.36 | $64.57 | $125.89 |
DeanCare Setting Facility Modifier None Typical Low $56.23 Median $87.10 Typical High $91.20 | Facility | None | $56.23 | $87.10 | $91.20 |
DeanCare Setting Professional Modifier None Typical Low $95.50 Median $97.72 Typical High $125.89 | Professional | None | $95.50 | $97.72 | $125.89 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $87.10 Typical High $107.15 | Facility | None | $56.23 | $87.10 | $107.15 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $436.52 | Professional | None | $33.11 | $43.65 | $436.52 |
Network Health Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $125.89 | Professional | None | $66.07 | $83.18 | $125.89 |
Prevea360 Setting Facility Modifier None Typical Low $56.23 Median $87.10 Typical High $91.20 | Facility | None | $56.23 | $87.10 | $91.20 |
Quartz Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $169.82 | Professional | None | $66.07 | $87.10 | $169.82 |
Quartz Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
The Alliance Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $165.96 | Professional | None | $85.11 | $100.00 | $165.96 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $10.96 Median $40.74 Typical High $66.07 | Professional | None | $10.96 | $40.74 | $66.07 |
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 $30.20 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $30.20 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $12.30 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $9.12 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.17 | $7.41 | $7.41 |
Where Wisconsin sits
The same service costs 2.7 times more in Hawaii than in Alabama. 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
$74.13
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.