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 $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $17.78 | Professional | None | $16.98 | $16.98 | $17.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.42 Median $22.39 Typical High $33.88 | Facility | None | $20.42 | $22.39 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $20.42 | Professional | None | $19.05 | $19.05 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $95.50 | Facility | None | $56.23 | $63.10 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $19.05 Typical High $28.84 | Professional | None | $9.77 | $19.05 | $28.84 |
DeanCare Setting Facility Modifier None Typical Low $16.60 Median $19.95 Typical High $20.89 | Facility | None | $16.60 | $19.95 | $20.89 |
DeanCare Setting Professional Modifier None Typical Low $21.88 Median $26.30 Typical High $26.30 | Professional | None | $21.88 | $26.30 | $26.30 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $19.95 Typical High $31.62 | Facility | None | $14.79 | $19.95 | $31.62 |
Medica Setting Professional Modifier None Typical Low $9.12 Median $10.00 Typical High $131.83 | Professional | None | $9.12 | $10.00 | $131.83 |
Network Health Setting Professional Modifier None Typical Low $15.14 Median $19.05 Typical High $28.84 | Professional | None | $15.14 | $19.05 | $28.84 |
Prevea360 Setting Facility Modifier None Typical Low $16.60 Median $19.95 Typical High $20.89 | Facility | None | $16.60 | $19.95 | $20.89 |
Quartz Setting Professional Modifier None Typical Low $19.50 Median $23.44 Typical High $50.12 | Professional | None | $19.50 | $23.44 | $50.12 |
Quartz Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
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 $6.03 Median $10.00 Typical High $15.14 | Professional | None | $6.03 | $10.00 | $15.14 |
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 $8.51 Median $8.51 Typical High $8.91 | Professional | 52 · Reduced service | $8.51 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $3.55 | Professional | 53 · Discontinued | $3.39 | $3.39 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $2.69 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $1.78 |
Where Wisconsin sits
The same service costs 3.2 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· 18th of 51
$16.98
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.