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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $89.13 | Professional | None | $77.62 | $89.13 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $117.49 Typical High $177.83 | Facility | None | $107.15 | $117.49 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | None | $100.00 | $100.00 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $331.13 Typical High $501.19 | Facility | None | $295.12 | $331.13 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $89.13 Typical High $151.36 | Professional | None | $45.71 | $89.13 | $151.36 |
DeanCare Setting Facility Modifier None Typical Low $77.62 Median $104.71 Typical High $109.65 | Facility | None | $77.62 | $104.71 | $109.65 |
DeanCare Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $173.78 | Professional | None | $114.82 | $154.88 | $173.78 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $104.71 Typical High $147.91 | Facility | None | $77.62 | $104.71 | $147.91 |
Medica Setting Professional Modifier None Typical Low $45.71 Median $52.48 Typical High $602.56 | Professional | None | $45.71 | $52.48 | $602.56 |
Network Health Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $151.36 | Professional | None | $79.43 | $100.00 | $151.36 |
Prevea360 Setting Facility Modifier None Typical Low $77.62 Median $104.71 Typical High $109.65 | Facility | None | $77.62 | $104.71 | $109.65 |
Quartz Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $234.42 | Professional | None | $91.20 | $117.49 | $234.42 |
Quartz Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
The Alliance Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $229.09 | Professional | None | $117.49 | $138.04 | $229.09 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
United Setting Professional Modifier None Typical Low $15.14 Median $48.98 Typical High $79.43 | Professional | None | $15.14 | $48.98 | $79.43 |
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 $38.90 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $38.90 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $15.85 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $11.75 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.76 | $8.91 | $8.91 |
Where Wisconsin sits
The same service costs 2.9 times more in Hawaii than in New York. 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· 8th of 51
$89.13
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.