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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $31.62 | Professional | None | $28.84 | $31.62 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $41.69 Typical High $63.10 | Facility | None | $38.02 | $41.69 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Professional | None | $35.48 | $35.48 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $117.49 Typical High $177.83 | Facility | None | $104.71 | $117.49 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $33.11 Typical High $53.70 | Professional | None | $16.60 | $33.11 | $53.70 |
DeanCare Setting Facility Modifier None Typical Low $28.84 Median $37.15 Typical High $38.90 | Facility | None | $28.84 | $37.15 | $38.90 |
DeanCare Setting Professional Modifier None Typical Low $33.88 Median $54.95 Typical High $64.57 | Professional | None | $33.88 | $54.95 | $64.57 |
Medica Setting Facility Modifier None Typical Low $28.84 Median $37.15 Typical High $54.95 | Facility | None | $28.84 | $37.15 | $54.95 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $18.62 Typical High $389.05 | Professional | None | $16.98 | $18.62 | $389.05 |
Network Health Setting Professional Modifier None Typical Low $28.18 Median $35.48 Typical High $53.70 | Professional | None | $28.18 | $35.48 | $53.70 |
Prevea360 Setting Facility Modifier None Typical Low $28.84 Median $37.15 Typical High $38.90 | Facility | None | $28.84 | $37.15 | $38.90 |
Quartz Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $87.10 | Professional | None | $33.88 | $42.66 | $87.10 |
Quartz Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
The Alliance Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $85.11 | Professional | None | $43.65 | $51.29 | $85.11 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $13.49 Median $17.78 Typical High $29.51 | Professional | None | $13.49 | $17.78 | $29.51 |
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 $14.13 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $14.13 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $5.75 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.27 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.88 | $3.16 | $3.16 |
Where Wisconsin sits
The same service costs 5.9 times more in Hawaii than in Utah. 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· 7th of 51
$31.62
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.