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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | None | $67.61 | $70.79 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $95.50 Typical High $141.25 | Facility | None | $87.10 | $95.50 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $87.10 | Professional | None | $79.43 | $79.43 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $269.15 Typical High $398.11 | Facility | None | $234.42 | $269.15 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $83.18 Typical High $123.03 | Professional | None | $38.02 | $83.18 | $123.03 |
DeanCare Setting Facility Modifier None Typical Low $69.18 Median $85.11 Typical High $89.13 | Facility | None | $69.18 | $85.11 | $89.13 |
DeanCare Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $117.49 | Professional | None | $93.33 | $109.65 | $117.49 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $85.11 Typical High $123.03 | Facility | None | $69.18 | $85.11 | $123.03 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $43.65 Typical High $436.52 | Professional | None | $38.02 | $43.65 | $436.52 |
Network Health Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $123.03 | Professional | None | $63.10 | $79.43 | $123.03 |
Prevea360 Setting Facility Modifier None Typical Low $69.18 Median $85.11 Typical High $89.13 | Facility | None | $69.18 | $85.11 | $89.13 |
Quartz Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $194.98 | Professional | None | $77.62 | $97.72 | $194.98 |
Quartz Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
The Alliance Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $194.98 | Professional | None | $100.00 | $114.82 | $194.98 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $12.88 Median $38.90 Typical High $63.10 | Professional | None | $12.88 | $38.90 | $63.10 |
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 $33.88 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $33.88 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $13.49 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.00 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.76 | $7.08 | $7.08 |
Where Wisconsin sits
The same service costs 2.6 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· 11th of 51
$70.79
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.