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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | None | $54.95 | $56.23 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $75.86 Typical High $112.20 | Facility | None | $69.18 | $75.86 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $69.18 | Professional | None | $64.57 | $64.57 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $213.80 Typical High $316.23 | Facility | None | $186.21 | $213.80 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $77.62 Typical High $97.72 | Professional | None | $33.11 | $77.62 | $97.72 |
DeanCare Setting Facility Modifier None Typical Low $54.95 Median $67.61 Typical High $70.79 | Facility | None | $54.95 | $67.61 | $70.79 |
DeanCare Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $117.49 | Professional | None | $107.15 | $109.65 | $117.49 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $67.61 Typical High $107.15 | Facility | None | $54.95 | $67.61 | $107.15 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $426.58 | Professional | None | $30.20 | $34.67 | $426.58 |
Network Health Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Network Health Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $97.72 | Professional | None | $50.12 | $64.57 | $97.72 |
Prevea360 Setting Facility Modifier None Typical Low $54.95 Median $67.61 Typical High $70.79 | Facility | None | $54.95 | $67.61 | $70.79 |
Quartz Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $169.82 | Professional | None | $66.07 | $77.62 | $169.82 |
Quartz Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
The Alliance Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $165.96 | Professional | None | $87.10 | $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 $12.88 Median $33.11 Typical High $50.12 | Professional | None | $12.88 | $33.11 | $50.12 |
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 $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $27.54 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $10.96 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $8.13 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $5.62 |
Where Wisconsin sits
The same service costs 3.0 times more in Montana than in Ohio. 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· 18th of 51
$56.23
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.