How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $9Professionalmedian $3 · 10th to 90th $1 to $5
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 $2.24 Median $2.24 Typical High $2.24 | Facility | None | $2.24 | $2.24 | $2.24 |
Aetna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $7.94 | Professional | None | $2.24 | $2.24 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.16 Median $3.47 Typical High $5.25 | Facility | None | $3.16 | $3.47 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.38 Median $3.16 Typical High $4.07 | Professional | None | $1.38 | $3.16 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $8.91 Typical High $13.80 | Facility | None | $1.86 | $8.91 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $2.29 Typical High $6.03 | Professional | None | $1.58 | $2.29 | $6.03 |
DeanCare Setting Facility Modifier None Typical Low $0.83 Median $3.09 Typical High $3.55 | Facility | None | $0.83 | $3.09 | $3.55 |
DeanCare Setting Professional Modifier None Typical Low $3.39 Median $5.37 Typical High $5.62 | Professional | None | $3.39 | $5.37 | $5.62 |
Medica Setting Facility Modifier None Typical Low $1.51 Median $3.09 Typical High $79.43 | Facility | None | $1.51 | $3.09 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.41 Median $1.95 Typical High $17.78 | Professional | None | $1.41 | $1.95 | $17.78 |
Network Health Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Facility | None | $5.01 | $5.01 | $5.01 |
Network Health Setting Professional Modifier None Typical Low $2.24 Median $2.88 Typical High $5.37 | Professional | None | $2.24 | $2.88 | $5.37 |
Prevea360 Setting Facility Modifier None Typical Low $0.83 Median $3.09 Typical High $3.55 | Facility | None | $0.83 | $3.09 | $3.55 |
Prevea360 Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $3.09 | Professional | None | $1.78 | $1.78 | $3.09 |
Quartz Setting Professional Modifier None Typical Low $3.16 Median $4.79 Typical High $6.76 | Professional | None | $3.16 | $4.79 | $6.76 |
Quartz Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $2.29 | Facility | None | $1.86 | $1.86 | $2.29 |
Quartz Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.29 | Professional | None | $1.58 | $1.58 | $2.29 |
Security Health Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Security Health Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $4.07 | Professional | None | $3.16 | $3.16 | $4.07 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.55 Typical High $2.88 | Professional | None | $1.02 | $1.55 | $2.88 |
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 $0.33 Median $0.33 Typical High $1.20 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.14 Median $0.14 Typical High $0.22 | Professional | RR · Rental | $0.14 | $0.14 | $0.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.05 Median $1.38 Typical High $1.51 | Professional | UE · Used equipment | $1.05 | $1.38 | $1.51 |
Where Wisconsin sits
The same service costs 3.0 times more in Hawaii than in New Hampshire. 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· 9th of 51
$2.95
HI $4.57NH $1.55
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.