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 $53.70 Median $56.23 Typical High $56.23 | Professional | None | $53.70 | $56.23 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $74.13 Typical High $112.20 | Facility | None | $67.61 | $74.13 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | None | $63.10 | $63.10 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $208.93 Typical High $316.23 | Facility | None | $186.21 | $208.93 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $75.86 Typical High $95.50 | Professional | None | $31.62 | $75.86 | $95.50 |
DeanCare Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $69.18 | Facility | None | $54.95 | $66.07 | $69.18 |
DeanCare Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $117.49 | Professional | None | $102.33 | $109.65 | $117.49 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $104.71 | Facility | None | $54.95 | $66.07 | $104.71 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $407.38 | Professional | None | $30.20 | $33.11 | $407.38 |
Network Health Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $95.50 | Professional | None | $50.12 | $63.10 | $95.50 |
Prevea360 Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $69.18 | Facility | None | $54.95 | $66.07 | $69.18 |
Quartz Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $165.96 | Professional | None | $64.57 | $77.62 | $165.96 |
Quartz Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Security Health Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
The Alliance Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $162.18 | Professional | None | $83.18 | $97.72 | $162.18 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $12.88 Median $32.36 Typical High $50.12 | Professional | None | $12.88 | $32.36 | $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 $26.92 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $26.92 | $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 $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.13 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.37 | $5.62 | $5.62 |
Where Wisconsin sits
The same service costs 2.8 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· 16th 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.