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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | None | $60.26 | $70.79 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $141.25 | Facility | None | $85.11 | $93.33 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | None | $79.43 | $79.43 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $263.03 Typical High $398.11 | Facility | None | $234.42 | $263.03 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $85.11 Typical High $120.23 | Professional | None | $30.90 | $85.11 | $120.23 |
DeanCare Setting Facility Modifier None Typical Low $69.18 Median $83.18 Typical High $87.10 | Facility | None | $69.18 | $83.18 | $87.10 |
DeanCare Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $154.88 | Professional | None | $91.20 | $154.88 | $154.88 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $83.18 Typical High $100.00 | Facility | None | $69.18 | $83.18 | $100.00 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $416.87 | Professional | None | $31.62 | $41.69 | $416.87 |
Network Health Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $120.23 | Professional | None | $63.10 | $79.43 | $120.23 |
Prevea360 Setting Facility Modifier None Typical Low $69.18 Median $83.18 Typical High $87.10 | Facility | None | $69.18 | $83.18 | $87.10 |
Quartz Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $158.49 | Professional | None | $63.10 | $83.18 | $158.49 |
Quartz Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $15.14 Median $38.90 Typical High $63.10 | Professional | None | $15.14 | $38.90 | $63.10 |
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 $30.20 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $30.20 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $12.02 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $8.91 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.03 | $7.08 | $7.08 |
Where Wisconsin sits
The same service costs 4.2 times more in Minnesota than in Alaska. 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· 4th of 51
$70.79
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.