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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | None | $107.15 | $107.15 | $109.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $144.54 Typical High $218.78 | Facility | None | $131.83 | $144.54 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | None | $123.03 | $123.03 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $407.38 Typical High $616.60 | Facility | None | $363.08 | $407.38 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $123.03 Typical High $186.21 | Professional | None | $63.10 | $123.03 | $186.21 |
DeanCare Setting Facility Modifier None Typical Low $107.15 Median $128.82 Typical High $134.90 | Facility | None | $107.15 | $128.82 | $134.90 |
DeanCare Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $190.55 | Professional | None | $141.25 | $154.88 | $190.55 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $128.82 Typical High $204.17 | Facility | None | $107.15 | $128.82 | $204.17 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $707.95 | Professional | None | $57.54 | $77.62 | $707.95 |
Network Health Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $186.21 | Professional | None | $97.72 | $123.03 | $186.21 |
Prevea360 Setting Facility Modifier None Typical Low $107.15 Median $128.82 Typical High $134.90 | Facility | None | $107.15 | $128.82 | $134.90 |
Quartz Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $323.59 | Professional | None | $128.82 | $147.91 | $323.59 |
Quartz Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $15.14 Median $64.57 Typical High $97.72 | Professional | None | $15.14 | $64.57 | $97.72 |
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 $53.70 Median $53.70 Typical High $54.95 | Professional | 52 · Reduced service | $53.70 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.60 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $10.96 |
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· 16th of 51
$107
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.