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 $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $12.02 | Professional | None | $10.23 | $10.23 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.59 Median $13.80 Typical High $20.89 | Facility | None | $12.59 | $13.80 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $12.59 | Professional | None | $11.75 | $11.75 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $38.90 Typical High $57.54 | Facility | None | $33.88 | $38.90 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $11.75 Typical High $17.78 | Professional | None | $6.03 | $11.75 | $17.78 |
DeanCare Setting Facility Modifier None Typical Low $10.23 Median $12.30 Typical High $12.88 | Facility | None | $10.23 | $12.30 | $12.88 |
DeanCare Setting Professional Modifier None Typical Low $11.22 Median $22.91 Typical High $26.92 | Professional | None | $11.22 | $22.91 | $26.92 |
Medica Setting Facility Modifier None Typical Low $10.23 Median $12.30 Typical High $19.50 | Facility | None | $10.23 | $12.30 | $19.50 |
Medica Setting Professional Modifier None Typical Low $5.50 Median $7.41 Typical High $81.28 | Professional | None | $5.50 | $7.41 | $81.28 |
Network Health Setting Professional Modifier None Typical Low $9.33 Median $11.75 Typical High $17.78 | Professional | None | $9.33 | $11.75 | $17.78 |
Prevea360 Setting Facility Modifier None Typical Low $10.23 Median $12.30 Typical High $12.88 | Facility | None | $10.23 | $12.30 | $12.88 |
Quartz Setting Professional Modifier None Typical Low $12.30 Median $14.13 Typical High $31.62 | Professional | None | $12.30 | $14.13 | $31.62 |
Quartz Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
The Alliance Setting Professional Modifier None Typical Low $15.85 Median $18.62 Typical High $30.90 | Professional | None | $15.85 | $18.62 | $30.90 |
United Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
United Setting Professional Modifier None Typical Low $3.98 Median $6.17 Typical High $10.23 | Professional | None | $3.98 | $6.17 | $10.23 |
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 $5.13 Median $5.13 Typical High $6.03 | Professional | 52 · Reduced service | $5.13 | $5.13 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.04 Typical High $2.40 | Professional | 53 · Discontinued | $2.04 | $2.04 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $1.55 Typical High $1.82 | Professional | 55 · Aftercare only | $1.55 | $1.55 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.20 |
Where Wisconsin sits
The same service costs 2.7 times more in Montana 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· 16th of 51
$10.96
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.