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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | None | $60.26 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $83.18 Typical High $123.03 | Facility | None | $75.86 | $83.18 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | None | $70.79 | $70.79 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $234.42 Typical High $346.74 | Facility | None | $204.17 | $234.42 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $83.18 Typical High $107.15 | Professional | None | $34.67 | $83.18 | $107.15 |
DeanCare Setting Facility Modifier None Typical Low $58.88 Median $74.13 Typical High $77.62 | Facility | None | $58.88 | $74.13 | $77.62 |
DeanCare Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $117.49 | Professional | None | $81.28 | $109.65 | $117.49 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $74.13 Typical High $112.20 | Facility | None | $58.88 | $74.13 | $112.20 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $37.15 Typical High $446.68 | Professional | None | $33.11 | $37.15 | $446.68 |
Network Health Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $107.15 | Professional | None | $54.95 | $70.79 | $107.15 |
Prevea360 Setting Facility Modifier None Typical Low $58.88 Median $74.13 Typical High $77.62 | Facility | None | $58.88 | $74.13 | $77.62 |
Quartz Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $177.83 | Professional | None | $69.18 | $85.11 | $177.83 |
Quartz Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
United Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $12.88 Median $34.67 Typical High $54.95 | Professional | None | $12.88 | $34.67 | $54.95 |
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 $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.02 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $6.17 |
Where Wisconsin sits
The same service costs 2.9 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· 15th of 51
$61.66
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.