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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | None | $77.62 | $77.62 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $104.71 Typical High $158.49 | Facility | None | $95.50 | $104.71 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $95.50 | Professional | None | $89.13 | $89.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $295.12 Typical High $446.68 | Facility | None | $263.03 | $295.12 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $89.13 Typical High $134.90 | Professional | None | $45.71 | $89.13 | $134.90 |
DeanCare Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $97.72 | Facility | None | $77.62 | $93.33 | $97.72 |
DeanCare Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $194.98 | Professional | None | $102.33 | $154.88 | $194.98 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $147.91 | Facility | None | $77.62 | $93.33 | $147.91 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $524.81 | Professional | None | $41.69 | $56.23 | $524.81 |
Network Health Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $134.90 | Professional | None | $70.79 | $89.13 | $134.90 |
Prevea360 Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $97.72 | Facility | None | $77.62 | $93.33 | $97.72 |
Quartz Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $239.88 | Professional | None | $93.33 | $107.15 | $239.88 |
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 $120.23 Median $141.25 Typical High $234.42 | Professional | None | $120.23 | $141.25 | $234.42 |
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 $46.77 Typical High $70.79 | Professional | None | $15.14 | $46.77 | $70.79 |
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 $38.90 Typical High $42.66 | Professional | 52 · Reduced service | $38.90 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $12.59 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $8.51 |
Where Wisconsin sits
The same service costs 2.3 times more in Hawaii than in Utah. 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
$83.18
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.