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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | None | $81.28 | $89.13 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $120.23 Typical High $177.83 | Facility | None | $107.15 | $120.23 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | None | $100.00 | $100.00 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $338.84 Typical High $501.19 | Facility | None | $295.12 | $338.84 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $85.11 Typical High $154.88 | Professional | None | $43.65 | $85.11 | $154.88 |
DeanCare Setting Facility Modifier None Typical Low $74.13 Median $107.15 Typical High $112.20 | Facility | None | $74.13 | $107.15 | $112.20 |
DeanCare Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $208.93 | Professional | None | $97.72 | $97.72 | $208.93 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $107.15 Typical High $141.25 | Facility | None | $74.13 | $107.15 | $141.25 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $588.84 | Professional | None | $44.67 | $52.48 | $588.84 |
Network Health Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $154.88 | Professional | None | $79.43 | $100.00 | $154.88 |
Prevea360 Setting Facility Modifier None Typical Low $74.13 Median $107.15 Typical High $112.20 | Facility | None | $74.13 | $107.15 | $112.20 |
Quartz Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $223.87 | Professional | None | $89.13 | $112.20 | $223.87 |
Quartz Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $10.96 Median $48.98 Typical High $79.43 | Professional | None | $10.96 | $48.98 | $79.43 |
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 $40.74 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $40.74 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $16.22 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $12.02 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.13 | $8.91 | $8.91 |
Where Wisconsin sits
The same service costs 3.5 times more in Hawaii than in New York. 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· 9th of 51
$89.13
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.