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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $107.15 Typical High $162.18 | Facility | None | $97.72 | $107.15 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | None | $91.20 | $91.20 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $302.00 Typical High $457.09 | Facility | None | $269.15 | $302.00 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $93.33 Typical High $138.04 | Professional | None | $46.77 | $93.33 | $138.04 |
DeanCare Setting Facility Modifier None Typical Low $79.43 Median $95.50 Typical High $100.00 | Facility | None | $79.43 | $95.50 | $100.00 |
DeanCare Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $190.55 | Professional | None | $104.71 | $154.88 | $190.55 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $95.50 Typical High $154.88 | Facility | None | $79.43 | $95.50 | $154.88 |
Medica Setting Professional Modifier None Typical Low $43.65 Median $57.54 Typical High $630.96 | Professional | None | $43.65 | $57.54 | $630.96 |
Network Health Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $138.04 | Professional | None | $72.44 | $91.20 | $138.04 |
Prevea360 Setting Facility Modifier None Typical Low $79.43 Median $95.50 Typical High $100.00 | Facility | None | $79.43 | $95.50 | $100.00 |
Quartz Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $245.47 | Professional | None | $95.50 | $112.20 | $245.47 |
Quartz Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $15.14 Median $47.86 Typical High $72.44 | Professional | None | $15.14 | $47.86 | $72.44 |
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 $40.74 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $8.13 |
Where Wisconsin sits
The same service costs 2.5 times more in Montana than in Missouri. 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· 15th of 51
$81.28
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.