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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $61.66 | Professional | None | $58.88 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $81.28 Typical High $123.03 | Facility | None | $74.13 | $81.28 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $74.13 | Professional | None | $69.18 | $69.18 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $229.09 Typical High $346.74 | Facility | None | $204.17 | $229.09 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $70.79 Typical High $107.15 | Professional | None | $35.48 | $70.79 | $107.15 |
DeanCare Setting Facility Modifier None Typical Low $60.26 Median $72.44 Typical High $75.86 | Facility | None | $60.26 | $72.44 | $75.86 |
DeanCare Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $114.82 | Professional | None | $66.07 | $97.72 | $114.82 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $72.44 Typical High $117.49 | Facility | None | $60.26 | $72.44 | $117.49 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $478.63 | Professional | None | $33.11 | $43.65 | $478.63 |
Network Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Network Health Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $107.15 | Professional | None | $54.95 | $69.18 | $107.15 |
Prevea360 Setting Facility Modifier None Typical Low $60.26 Median $72.44 Typical High $75.86 | Facility | None | $60.26 | $72.44 | $75.86 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $186.21 | Professional | None | $72.44 | $85.11 | $186.21 |
Quartz Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Security Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $28.84 Median $36.31 Typical High $60.26 | Professional | None | $28.84 | $36.31 | $60.26 |
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 $29.51 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $29.51 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $11.75 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $8.91 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.89 | $6.17 | $6.17 |
Where Wisconsin sits
The same service costs 2.8 times more in Montana than in Alabama. 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· 19th of 51
$61.66
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.