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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.78 Typical High $18.20 | Professional | None | $17.38 | $17.78 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.88 Median $23.99 Typical High $36.31 | Facility | None | $21.88 | $23.99 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $21.88 | Professional | None | $20.42 | $20.42 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $67.61 Typical High $100.00 | Facility | None | $58.88 | $67.61 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $19.05 Typical High $30.90 | Professional | None | $9.55 | $19.05 | $30.90 |
DeanCare Setting Facility Modifier None Typical Low $16.60 Median $21.38 Typical High $22.39 | Facility | None | $16.60 | $21.38 | $22.39 |
DeanCare Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $26.30 | Professional | None | $19.50 | $19.50 | $26.30 |
Medica Setting Facility Modifier None Typical Low $16.60 Median $21.38 Typical High $31.62 | Facility | None | $16.60 | $21.38 | $31.62 |
Medica Setting Professional Modifier None Typical Low $9.55 Median $10.72 Typical High $123.03 | Professional | None | $9.55 | $10.72 | $123.03 |
Network Health Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Network Health Setting Professional Modifier None Typical Low $16.22 Median $20.42 Typical High $30.90 | Professional | None | $16.22 | $20.42 | $30.90 |
Prevea360 Setting Facility Modifier None Typical Low $16.60 Median $21.38 Typical High $22.39 | Facility | None | $16.60 | $21.38 | $22.39 |
Quartz Setting Professional Modifier None Typical Low $19.50 Median $24.55 Typical High $50.12 | Professional | None | $19.50 | $24.55 | $50.12 |
Quartz Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
The Alliance Setting Professional Modifier None Typical Low $25.70 Median $29.51 Typical High $48.98 | Professional | None | $25.70 | $29.51 | $48.98 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
United Setting Professional Modifier None Typical Low $8.13 Median $10.72 Typical High $30.90 | Professional | None | $8.13 | $10.72 | $30.90 |
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 $8.91 Median $8.91 Typical High $9.12 | Professional | 52 · Reduced service | $8.91 | $8.91 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.63 Typical High $3.72 | Professional | 53 · Discontinued | $3.55 | $3.63 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.75 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.78 | $1.82 | $1.82 |
Where Wisconsin sits
The same service costs 3.0 times more in Montana 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
$19.05
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.