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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | None | $93.33 | $97.72 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $128.82 Typical High $194.98 | Facility | None | $117.49 | $128.82 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $117.49 | Professional | None | $109.65 | $109.65 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $363.08 Typical High $549.54 | Facility | None | $323.59 | $363.08 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $102.33 Typical High $165.96 | Professional | None | $52.48 | $102.33 | $165.96 |
DeanCare Setting Facility Modifier None Typical Low $89.13 Median $114.82 Typical High $120.23 | Facility | None | $89.13 | $114.82 | $120.23 |
DeanCare Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $218.78 | Professional | None | $125.89 | $154.88 | $218.78 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $114.82 Typical High $173.78 | Facility | None | $89.13 | $114.82 | $173.78 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $776.25 | Professional | None | $52.48 | $57.54 | $776.25 |
Network Health Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $165.96 | Professional | None | $87.10 | $109.65 | $165.96 |
Prevea360 Setting Facility Modifier None Typical Low $89.13 Median $114.82 Typical High $120.23 | Facility | None | $89.13 | $114.82 | $120.23 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $275.42 | Professional | None | $107.15 | $134.90 | $275.42 |
Quartz Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $15.14 Median $53.70 Typical High $87.10 | Professional | None | $15.14 | $53.70 | $87.10 |
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 $46.77 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $46.77 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $18.62 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $13.80 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.33 | $9.77 | $9.77 |
Where Wisconsin sits
The same service costs 4.2 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· 9th of 51
$97.72
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.