How much rates vary
Facilitymedian $21 · 10th to 90th $12 to $58Professionalmedian $19 · 10th to 90th $9 to $32
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 $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $38.02 | Professional | None | $14.79 | $14.79 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.89 Median $23.44 Typical High $34.67 | Facility | None | $20.89 | $23.44 | $34.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $20.89 Typical High $27.54 | Professional | None | $9.33 | $20.89 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $57.54 Typical High $89.13 | Facility | None | $12.30 | $57.54 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $16.22 Typical High $39.81 | Professional | None | $10.47 | $16.22 | $39.81 |
DeanCare Setting Facility Modifier None Typical Low $5.62 Median $20.89 Typical High $23.99 | Facility | None | $5.62 | $20.89 | $23.99 |
DeanCare Setting Professional Modifier None Typical Low $26.30 Median $30.20 Typical High $32.36 | Professional | None | $26.30 | $30.20 | $32.36 |
Medica Setting Facility Modifier None Typical Low $10.00 Median $20.89 Typical High $91.20 | Facility | None | $10.00 | $20.89 | $91.20 |
Medica Setting Professional Modifier None Typical Low $8.71 Median $13.18 Typical High $112.20 | Professional | None | $8.71 | $13.18 | $112.20 |
Network Health Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Network Health Setting Professional Modifier None Typical Low $15.14 Median $19.50 Typical High $36.31 | Professional | None | $15.14 | $19.50 | $36.31 |
Prevea360 Setting Facility Modifier None Typical Low $5.62 Median $20.89 Typical High $23.99 | Facility | None | $5.62 | $20.89 | $23.99 |
Prevea360 Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $20.89 | Professional | None | $11.75 | $11.75 | $20.89 |
Quartz Setting Professional Modifier None Typical Low $19.05 Median $28.18 Typical High $44.67 | Professional | None | $19.05 | $28.18 | $44.67 |
Quartz Setting Facility Modifier None Typical Low $8.91 Median $12.30 Typical High $13.18 | Facility | None | $8.91 | $12.30 | $13.18 |
Quartz Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $13.18 | Professional | None | $10.47 | $10.47 | $13.18 |
Security Health Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Security Health Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $27.54 | Professional | None | $20.89 | $20.89 | $27.54 |
United Setting Professional Modifier None Typical Low $6.92 Median $10.23 Typical High $19.05 | Professional | None | $6.92 | $10.23 | $19.05 |
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 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $5.75 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $3.80 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $3.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.93 Median $0.93 Typical High $1.38 | Professional | RR · Rental | $0.93 | $0.93 | $1.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.08 Median $7.59 Typical High $9.33 | Professional | UE · Used equipment | $7.08 | $7.59 | $9.33 |
Where Wisconsin sits
The same service costs 3.0 times more in Hawaii than in Rhode Island. 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· 6th of 51
$19.50
HI $28.18RI $9.33
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.