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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $26.30 Typical High $26.30 | Professional | None | $21.88 | $26.30 | $26.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $35.48 Typical High $52.48 | Facility | None | $31.62 | $35.48 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $31.62 | Professional | None | $29.51 | $29.51 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $147.91 | Facility | None | $87.10 | $100.00 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $24.55 Typical High $45.71 | Professional | None | $12.30 | $24.55 | $45.71 |
DeanCare Setting Facility Modifier None Typical Low $21.38 Median $31.62 Typical High $33.11 | Facility | None | $21.38 | $31.62 | $33.11 |
DeanCare Setting Professional Modifier None Typical Low $28.18 Median $57.54 Typical High $67.61 | Professional | None | $28.18 | $57.54 | $67.61 |
Medica Setting Facility Modifier None Typical Low $21.38 Median $31.62 Typical High $40.74 | Facility | None | $21.38 | $31.62 | $40.74 |
Medica Setting Professional Modifier None Typical Low $12.59 Median $15.49 Typical High $165.96 | Professional | None | $12.59 | $15.49 | $165.96 |
Network Health Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Network Health Setting Professional Modifier None Typical Low $23.44 Median $29.51 Typical High $45.71 | Professional | None | $23.44 | $29.51 | $45.71 |
Prevea360 Setting Facility Modifier None Typical Low $21.38 Median $31.62 Typical High $33.11 | Facility | None | $21.38 | $31.62 | $33.11 |
Quartz Setting Professional Modifier None Typical Low $25.12 Median $31.62 Typical High $63.10 | Professional | None | $25.12 | $31.62 | $63.10 |
Quartz Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $10.47 Median $14.79 Typical High $25.12 | Professional | None | $10.47 | $14.79 | $25.12 |
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 $10.96 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $10.96 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $4.37 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $3.24 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.63 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.19 | $2.63 | $2.63 |
Where Wisconsin sits
The same service costs 3.5 times more in Hawaii 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· 8th of 51
$26.30
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.