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 $72.44 Median $74.13 Typical High $74.13 | Professional | None | $72.44 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $100.00 Typical High $147.91 | Facility | None | $91.20 | $100.00 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $91.20 | Professional | None | $85.11 | $85.11 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $281.84 Typical High $416.87 | Facility | None | $245.47 | $281.84 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $72.44 Typical High $128.82 | Professional | None | $37.15 | $72.44 | $128.82 |
DeanCare Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $93.33 | Facility | None | $63.10 | $89.13 | $93.33 |
DeanCare Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $162.18 | Professional | None | $97.72 | $97.72 | $162.18 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $120.23 | Facility | None | $63.10 | $89.13 | $120.23 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $478.63 | Professional | None | $37.15 | $44.67 | $478.63 |
Network Health Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $128.82 | Professional | None | $66.07 | $85.11 | $128.82 |
Prevea360 Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $93.33 | Facility | None | $63.10 | $89.13 | $93.33 |
Quartz Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $190.55 | Professional | None | $75.86 | $95.50 | $190.55 |
Quartz Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $10.96 Median $41.69 Typical High $66.07 | Professional | None | $10.96 | $41.69 | $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 $35.48 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $35.48 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.45 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.24 | $7.41 | $7.41 |
Where Wisconsin sits
The same service costs 2.6 times more in Montana than in Nebraska. 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· 7th 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.