How much rates vary
Facilitymedian $7 · 10th to 90th $4 to $19Professionalmedian $6 · 10th to 90th $3 to $10
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 $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $10.96 | Professional | None | $4.90 | $4.90 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.08 Median $7.76 Typical High $11.48 | Facility | None | $7.08 | $7.76 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $7.08 Typical High $9.12 | Professional | None | $3.09 | $7.08 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $19.05 Typical High $28.84 | Facility | None | $4.17 | $19.05 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $5.13 Typical High $13.18 | Professional | None | $3.55 | $5.13 | $13.18 |
DeanCare Setting Facility Modifier None Typical Low $1.91 Median $6.92 Typical High $7.94 | Facility | None | $1.91 | $6.92 | $7.94 |
DeanCare Setting Professional Modifier None Typical Low $8.51 Median $13.80 Typical High $14.45 | Professional | None | $8.51 | $13.80 | $14.45 |
Medica Setting Facility Modifier None Typical Low $3.39 Median $6.92 Typical High $79.43 | Facility | None | $3.39 | $6.92 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.16 Median $4.37 Typical High $33.88 | Professional | None | $3.16 | $4.37 | $33.88 |
Network Health Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Network Health Setting Professional Modifier None Typical Low $5.01 Median $6.46 Typical High $12.02 | Professional | None | $5.01 | $6.46 | $12.02 |
Prevea360 Setting Facility Modifier None Typical Low $1.91 Median $6.92 Typical High $7.94 | Facility | None | $1.91 | $6.92 | $7.94 |
Prevea360 Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $6.92 | Professional | None | $3.98 | $3.98 | $6.92 |
Quartz Setting Professional Modifier None Typical Low $6.31 Median $9.33 Typical High $14.45 | Professional | None | $6.31 | $9.33 | $14.45 |
Quartz Setting Facility Modifier None Typical Low $3.16 Median $4.17 Typical High $5.01 | Facility | None | $3.16 | $4.17 | $5.01 |
Quartz Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.90 | Professional | None | $3.55 | $3.55 | $4.90 |
Security Health Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Security Health Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $9.12 | Professional | None | $7.08 | $7.08 | $9.12 |
United Setting Professional Modifier None Typical Low $2.29 Median $3.47 Typical High $6.31 | Professional | None | $2.29 | $3.47 | $6.31 |
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 $0.74 Median $0.74 Typical High $1.66 | Professional | 55 · Aftercare only | $0.74 | $0.74 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.50 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.50 | $0.50 | $1.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.31 Median $0.31 Typical High $0.49 | Professional | RR · Rental | $0.31 | $0.31 | $0.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.34 Median $2.51 Typical High $3.09 | Professional | UE · Used equipment | $2.34 | $2.51 | $3.09 |
Where Wisconsin sits
The same service costs 2.1 times more in Idaho 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
$6.46
ID $7.24CT $3.39
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.