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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | None | $114.82 | $120.23 | $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 $398.11 Median $457.09 Typical High $676.08 | Facility | None | $398.11 | $457.09 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $208.93 | Professional | None | $58.88 | $117.49 | $208.93 |
DeanCare Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $151.36 | Facility | None | $117.49 | $141.25 | $151.36 |
DeanCare Setting Professional Modifier None Typical Low $128.82 Median $398.11 Typical High $467.74 | Professional | None | $128.82 | $398.11 | $467.74 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $169.82 | Facility | None | $100.00 | $141.25 | $169.82 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $707.95 | Professional | None | $60.26 | $70.79 | $707.95 |
Network Health Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $223.87 | Professional | None | $107.15 | $134.90 | $223.87 |
Prevea360 Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $151.36 | Facility | None | $117.49 | $141.25 | $151.36 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $316.23 | Professional | None | $125.89 | $158.49 | $316.23 |
Quartz Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $47.86 Median $70.79 Typical High $114.82 | Professional | None | $47.86 | $70.79 | $114.82 |
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 $57.54 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $57.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.99 Typical High $24.55 | Professional | 53 · Discontinued | $22.91 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $17.38 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.48 | $12.02 | $12.02 |
Where Wisconsin sits
The same service costs 3.0 times more in California than in New York. 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· 12th of 51
$120
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.