How much rates vary
Facilitymedian $38 · 10th to 90th $22 to $102Professionalmedian $35 · 10th to 90th $17 to $56
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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $77.62 | Professional | None | $26.30 | $26.30 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $41.69 Typical High $61.66 | Facility | None | $38.02 | $41.69 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $38.02 Typical High $46.77 | Professional | None | $16.60 | $38.02 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $102.33 Typical High $158.49 | Facility | None | $21.88 | $102.33 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $26.30 Typical High $70.79 | Professional | None | $18.62 | $26.30 | $70.79 |
DeanCare Setting Facility Modifier None Typical Low $10.00 Median $37.15 Typical High $42.66 | Facility | None | $10.00 | $37.15 | $42.66 |
DeanCare Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $52.48 | Professional | None | $45.71 | $50.12 | $52.48 |
Medica Setting Facility Modifier None Typical Low $8.13 Median $37.15 Typical High $165.96 | Facility | None | $8.13 | $37.15 | $165.96 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $23.44 Typical High $194.98 | Professional | None | $16.98 | $23.44 | $194.98 |
Network Health Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Network Health Setting Professional Modifier None Typical Low $26.92 Median $34.67 Typical High $64.57 | Professional | None | $26.92 | $34.67 | $64.57 |
Prevea360 Setting Facility Modifier None Typical Low $10.00 Median $37.15 Typical High $42.66 | Facility | None | $10.00 | $37.15 | $42.66 |
Prevea360 Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $37.15 | Professional | None | $20.89 | $20.89 | $37.15 |
Quartz Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $79.43 | Professional | None | $34.67 | $50.12 | $79.43 |
Quartz Setting Facility Modifier None Typical Low $18.20 Median $21.88 Typical High $23.44 | Facility | None | $18.20 | $21.88 | $23.44 |
Quartz Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $23.44 | Professional | None | $18.62 | $18.62 | $23.44 |
Security Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Security Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $48.98 | Professional | None | $38.02 | $38.02 | $48.98 |
United Setting Professional Modifier None Typical Low $12.30 Median $18.20 Typical High $33.88 | Professional | None | $12.30 | $18.20 | $33.88 |
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 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $11.48 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $7.76 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $7.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.66 Median $1.66 Typical High $2.51 | Professional | RR · Rental | $1.66 | $1.66 | $2.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.59 Median $12.59 Typical High $13.49 | Professional | UE · Used equipment | $12.59 | $12.59 | $13.49 |
Where Wisconsin sits
The same service costs 2.9 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· 7th of 51
$34.67
HI $47.86RI $16.60
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.