How much rates vary
Facilitymedian $26 · 10th to 90th $15 to $71Professionalmedian $24 · 10th to 90th $12 to $39
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 $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $44.67 | Professional | None | $18.20 | $18.20 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $28.18 Typical High $42.66 | Facility | None | $25.70 | $28.18 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $25.70 Typical High $32.36 | Professional | None | $10.72 | $25.70 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $70.79 Typical High $107.15 | Facility | None | $15.14 | $70.79 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $17.78 Typical High $48.98 | Professional | None | $12.88 | $17.78 | $48.98 |
DeanCare Setting Facility Modifier None Typical Low $6.92 Median $25.12 Typical High $28.84 | Facility | None | $6.92 | $25.12 | $28.84 |
DeanCare Setting Professional Modifier None Typical Low $31.62 Median $37.15 Typical High $39.81 | Professional | None | $31.62 | $37.15 | $39.81 |
Medica Setting Facility Modifier None Typical Low $12.30 Median $25.12 Typical High $112.20 | Facility | None | $12.30 | $25.12 | $112.20 |
Medica Setting Professional Modifier None Typical Low $11.48 Median $16.22 Typical High $144.54 | Professional | None | $11.48 | $16.22 | $144.54 |
Network Health Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Network Health Setting Professional Modifier None Typical Low $18.20 Median $23.44 Typical High $43.65 | Professional | None | $18.20 | $23.44 | $43.65 |
Prevea360 Setting Facility Modifier None Typical Low $6.92 Median $25.12 Typical High $28.84 | Facility | None | $6.92 | $25.12 | $28.84 |
Prevea360 Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $25.12 | Professional | None | $14.45 | $14.45 | $25.12 |
Quartz Setting Professional Modifier None Typical Low $23.44 Median $33.88 Typical High $54.95 | Professional | None | $23.44 | $33.88 | $54.95 |
Quartz Setting Facility Modifier None Typical Low $12.02 Median $15.14 Typical High $16.22 | Facility | None | $12.02 | $15.14 | $16.22 |
Quartz Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $16.22 | Professional | None | $12.88 | $12.88 | $16.22 |
Security Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Security Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $33.11 | Professional | None | $25.70 | $25.70 | $33.11 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.59 Typical High $23.44 | Professional | None | $8.32 | $12.59 | $23.44 |
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 $2.69 Median $2.69 Typical High $6.76 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $4.47 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $4.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.07 Median $1.07 Typical High $1.70 | Professional | RR · Rental | $1.07 | $1.07 | $1.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.13 Median $8.13 Typical High $10.72 | Professional | UE · Used equipment | $8.13 | $8.13 | $10.72 |
Where Wisconsin sits
The same service costs 3.5 times more in Hawaii than in Connecticut. 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
$23.99
HI $37.15CT $10.72
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.