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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $20.42 | Professional | None | $19.50 | $19.50 | $20.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.99 Median $26.30 Typical High $39.81 | Facility | None | $23.99 | $26.30 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $23.99 | Professional | None | $22.39 | $22.39 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $74.13 Typical High $109.65 | Facility | None | $64.57 | $74.13 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $22.39 Typical High $33.88 | Professional | None | $11.48 | $22.39 | $33.88 |
DeanCare Setting Facility Modifier None Typical Low $19.50 Median $23.44 Typical High $24.55 | Facility | None | $19.50 | $23.44 | $24.55 |
DeanCare Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $28.18 | Professional | None | $21.38 | $21.38 | $28.18 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $23.44 Typical High $37.15 | Facility | None | $19.50 | $23.44 | $37.15 |
Medica Setting Professional Modifier None Typical Low $10.47 Median $14.13 Typical High $208.93 | Professional | None | $10.47 | $14.13 | $208.93 |
Network Health Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Network Health Setting Professional Modifier None Typical Low $17.38 Median $22.39 Typical High $33.88 | Professional | None | $17.38 | $22.39 | $33.88 |
Prevea360 Setting Facility Modifier None Typical Low $19.50 Median $23.44 Typical High $24.55 | Facility | None | $19.50 | $23.44 | $24.55 |
Quartz Setting Professional Modifier None Typical Low $23.44 Median $26.92 Typical High $58.88 | Professional | None | $23.44 | $26.92 | $58.88 |
Quartz Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
United Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $9.12 Median $11.75 Typical High $19.50 | Professional | None | $9.12 | $11.75 | $19.50 |
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 $9.77 Median $9.77 Typical High $10.00 | Professional | 52 · Reduced service | $9.77 | $9.77 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $4.07 | Professional | 53 · Discontinued | $3.89 | $3.89 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $3.02 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $2.04 |
Where Wisconsin sits
The same service costs 4.6 times more in Hawaii than in Ohio. 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· 13th of 51
$21.38
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.