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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $74.13 | Professional | None | $67.61 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $100.00 Typical High $147.91 | Facility | None | $89.13 | $100.00 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | None | $83.18 | $83.18 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $281.84 Typical High $416.87 | Facility | None | $245.47 | $281.84 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $74.13 Typical High $128.82 | Professional | None | $38.02 | $74.13 | $128.82 |
DeanCare Setting Facility Modifier None Typical Low $72.44 Median $89.13 Typical High $93.33 | Facility | None | $72.44 | $89.13 | $93.33 |
DeanCare Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $147.91 | Professional | None | $79.43 | $125.89 | $147.91 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $89.13 Typical High $123.03 | Facility | None | $72.44 | $89.13 | $123.03 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $489.78 | Professional | None | $38.02 | $45.71 | $489.78 |
Network Health Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $128.82 | Professional | None | $66.07 | $83.18 | $128.82 |
Prevea360 Setting Facility Modifier None Typical Low $72.44 Median $89.13 Typical High $93.33 | Facility | None | $72.44 | $89.13 | $93.33 |
Quartz Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $194.98 | Professional | None | $77.62 | $97.72 | $194.98 |
Quartz Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $30.20 Median $43.65 Typical High $70.79 | Professional | None | $30.20 | $43.65 | $70.79 |
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 $33.88 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $33.88 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $13.49 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.00 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.76 | $7.41 | $7.41 |
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· 12th of 51
$74.13
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.