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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $81.28 Typical High $120.23 | Facility | None | $74.13 | $81.28 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | None | $67.61 | $67.61 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $229.09 Typical High $338.84 | Facility | None | $199.53 | $229.09 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $83.18 Typical High $104.71 | Professional | None | $35.48 | $83.18 | $104.71 |
DeanCare Setting Facility Modifier None Typical Low $58.88 Median $72.44 Typical High $75.86 | Facility | None | $58.88 | $72.44 | $75.86 |
DeanCare Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $120.23 | Professional | None | $79.43 | $109.65 | $120.23 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $72.44 Typical High $114.82 | Facility | None | $58.88 | $72.44 | $114.82 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $446.68 | Professional | None | $32.36 | $43.65 | $446.68 |
Network Health Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $104.71 | Professional | None | $53.70 | $67.61 | $104.71 |
Prevea360 Setting Facility Modifier None Typical Low $58.88 Median $72.44 Typical High $75.86 | Facility | None | $58.88 | $72.44 | $75.86 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $181.97 | Professional | None | $72.44 | $83.18 | $181.97 |
Quartz Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
The Alliance Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $177.83 | Professional | None | $93.33 | $107.15 | $177.83 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $12.88 Median $36.31 Typical High $53.70 | Professional | None | $12.88 | $36.31 | $53.70 |
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 $30.20 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.17 |
Where Wisconsin sits
The same service costs 2.9 times more in Hawaii 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· 18th 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.