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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $120.23 | Professional | None | $117.49 | $117.49 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $144.54 Median $158.49 Typical High $239.88 | Facility | None | $144.54 | $158.49 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | None | $134.90 | $134.90 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $446.68 Typical High $660.69 | Facility | None | $389.05 | $446.68 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $134.90 Typical High $204.17 | Professional | None | $69.18 | $134.90 | $204.17 |
DeanCare Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $147.91 | Facility | None | $117.49 | $141.25 | $147.91 |
DeanCare Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $169.82 | Professional | None | $128.82 | $128.82 | $169.82 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $223.87 | Facility | None | $117.49 | $141.25 | $223.87 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $851.14 | Professional | None | $63.10 | $85.11 | $851.14 |
Network Health Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $204.17 | Professional | None | $104.71 | $134.90 | $204.17 |
Prevea360 Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $147.91 | Facility | None | $117.49 | $141.25 | $147.91 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $354.81 | Professional | None | $141.25 | $162.18 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $15.14 Median $70.79 Typical High $107.15 | Professional | None | $15.14 | $70.79 | $107.15 |
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 $58.88 Median $58.88 Typical High $60.26 | Professional | 52 · Reduced service | $58.88 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $23.99 | Professional | 53 · Discontinued | $23.44 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $18.20 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.02 |
Where Wisconsin sits
The same service costs 3.0 times more in Hawaii than in Indiana. 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
$117
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.