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 $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | None | $309.03 | $309.03 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $407.38 Typical High $616.60 | Facility | None | $371.54 | $407.38 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $371.54 | Professional | None | $346.74 | $346.74 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,737.80 | Facility | None | $1,023.29 | $1,148.15 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $346.74 Typical High $524.81 | Professional | None | $177.83 | $346.74 | $524.81 |
DeanCare Setting Facility Modifier None Typical Low $302.00 Median $363.08 Typical High $407.38 | Facility | None | $302.00 | $363.08 | $407.38 |
DeanCare Setting Professional Modifier None Typical Low $331.13 Median $630.96 Typical High $741.31 | Professional | None | $331.13 | $630.96 | $741.31 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $363.08 Typical High $588.84 | Facility | None | $302.00 | $363.08 | $588.84 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $2,398.83 | Professional | None | $165.96 | $218.78 | $2,398.83 |
Network Health Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $524.81 | Professional | None | $275.42 | $346.74 | $524.81 |
Prevea360 Setting Facility Modifier None Typical Low $302.00 Median $363.08 Typical High $407.38 | Facility | None | $302.00 | $363.08 | $407.38 |
Quartz Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $933.25 | Professional | None | $363.08 | $426.58 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
United Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
United Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $302.00 | Professional | None | $141.25 | $181.97 | $302.00 |
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 $154.88 Median $154.88 Typical High $173.78 | Professional | 52 · Reduced service | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $69.18 | Professional | 53 · Discontinued | $61.66 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $34.67 |
Where Wisconsin sits
The same service costs 4.4 times more in Hawaii than in Florida. 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
$339
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.