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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $147.91 | Professional | None | $141.25 | $147.91 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $199.53 Typical High $295.12 | Facility | None | $177.83 | $199.53 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | None | $165.96 | $165.96 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $562.34 Typical High $831.76 | Facility | None | $489.78 | $562.34 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $257.04 | Professional | None | $87.10 | $169.82 | $257.04 |
DeanCare Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $186.21 | Facility | None | $144.54 | $177.83 | $186.21 |
DeanCare Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | None | $154.88 | $154.88 | $158.49 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $281.84 | Facility | None | $144.54 | $177.83 | $281.84 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $1,778.28 | Professional | None | $79.43 | $104.71 | $1,778.28 |
Network Health Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $257.04 | Professional | None | $131.83 | $165.96 | $257.04 |
Prevea360 Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $186.21 | Facility | None | $144.54 | $177.83 | $186.21 |
Quartz Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $446.68 | Professional | None | $173.78 | $204.17 | $446.68 |
Quartz Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $15.14 Median $87.10 Typical High $131.83 | Professional | None | $15.14 | $87.10 | $131.83 |
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 $70.79 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $70.79 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $28.18 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.13 | $14.79 | $14.79 |
Where Wisconsin sits
The same service costs 5.0 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· 17th of 51
$148
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.