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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | None | $75.86 | $75.86 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $154.88 | Facility | None | $93.33 | $102.33 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | None | $87.10 | $87.10 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $288.40 Typical High $426.58 | Facility | None | $251.19 | $288.40 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $83.18 Typical High $131.83 | Professional | None | $41.69 | $83.18 | $131.83 |
DeanCare Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $95.50 | Facility | None | $70.79 | $91.20 | $95.50 |
DeanCare Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $177.83 | Professional | None | $100.00 | $109.65 | $177.83 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $138.04 | Facility | None | $70.79 | $91.20 | $138.04 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $45.71 Typical High $467.74 | Professional | None | $40.74 | $45.71 | $467.74 |
Network Health Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $131.83 | Professional | None | $67.61 | $87.10 | $131.83 |
Prevea360 Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $95.50 | Facility | None | $70.79 | $91.20 | $95.50 |
Quartz Setting Professional Modifier None Typical Low $85.11 Median $104.71 Typical High $218.78 | Professional | None | $85.11 | $104.71 | $218.78 |
Quartz Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $12.88 Median $42.66 Typical High $69.18 | Professional | None | $12.88 | $42.66 | $69.18 |
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 $38.02 Median $38.02 Typical High $38.90 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.49 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.22 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.76 |
Where Wisconsin sits
The same service costs 2.4 times more in Hawaii 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· 14th of 51
$75.86
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.