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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | None | $63.10 | $64.57 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $87.10 Typical High $131.83 | Facility | None | $79.43 | $87.10 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | None | $74.13 | $74.13 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $245.47 Typical High $363.08 | Facility | None | $213.80 | $245.47 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $70.79 Typical High $112.20 | Professional | None | $33.88 | $70.79 | $112.20 |
DeanCare Setting Facility Modifier None Typical Low $64.57 Median $77.62 Typical High $81.28 | Facility | None | $64.57 | $77.62 | $81.28 |
DeanCare Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $104.71 | Professional | None | $70.79 | $89.13 | $104.71 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $77.62 Typical High $112.20 | Facility | None | $64.57 | $77.62 | $112.20 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $38.90 Typical High $389.05 | Professional | None | $34.67 | $38.90 | $389.05 |
Network Health Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $112.20 | Professional | None | $56.23 | $74.13 | $112.20 |
Prevea360 Setting Facility Modifier None Typical Low $64.57 Median $77.62 Typical High $81.28 | Facility | None | $64.57 | $77.62 | $81.28 |
Quartz Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $177.83 | Professional | None | $69.18 | $87.10 | $177.83 |
Quartz Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
The Alliance Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $173.78 | Professional | None | $89.13 | $97.72 | $173.78 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $58.88 | Professional | None | $26.92 | $36.31 | $58.88 |
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 $31.62 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $31.62 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $12.59 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.31 | $6.46 | $6.46 |
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· 10th of 51
$64.57
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.