How much rates vary
Facilitymedian $23 · 10th to 90th $13 to $59Professionalmedian $21 · 10th to 90th $10 to $35
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 $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $42.66 | Professional | None | $16.22 | $16.22 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $25.12 Typical High $38.02 | Facility | None | $22.91 | $25.12 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $22.91 Typical High $28.18 | Professional | None | $10.00 | $22.91 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $58.88 Typical High $91.20 | Facility | None | $13.49 | $58.88 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $16.60 Typical High $43.65 | Professional | None | $11.48 | $16.60 | $43.65 |
DeanCare Setting Facility Modifier None Typical Low $6.17 Median $22.39 Typical High $25.70 | Facility | None | $6.17 | $22.39 | $25.70 |
DeanCare Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $38.90 | Professional | None | $24.55 | $37.15 | $38.90 |
Medica Setting Facility Modifier None Typical Low $10.96 Median $22.39 Typical High $102.33 | Facility | None | $10.96 | $22.39 | $102.33 |
Medica Setting Professional Modifier None Typical Low $10.00 Median $14.45 Typical High $109.65 | Professional | None | $10.00 | $14.45 | $109.65 |
Network Health Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Network Health Setting Professional Modifier None Typical Low $16.22 Median $20.89 Typical High $38.90 | Professional | None | $16.22 | $20.89 | $38.90 |
Prevea360 Setting Facility Modifier None Typical Low $6.17 Median $22.39 Typical High $25.70 | Facility | None | $6.17 | $22.39 | $25.70 |
Prevea360 Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $22.39 | Professional | None | $10.96 | $10.96 | $22.39 |
Quartz Setting Professional Modifier None Typical Low $20.89 Median $30.20 Typical High $48.98 | Professional | None | $20.89 | $30.20 | $48.98 |
Quartz Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $14.45 | Facility | None | $9.55 | $13.49 | $14.45 |
Quartz Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $14.45 | Professional | None | $11.48 | $11.48 | $14.45 |
Security Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Security Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $29.51 | Professional | None | $22.91 | $22.91 | $29.51 |
United Setting Professional Modifier None Typical Low $7.41 Median $11.22 Typical High $20.89 | Professional | None | $7.41 | $11.22 | $20.89 |
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 $2.40 Median $2.40 Typical High $6.46 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $4.27 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $4.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.00 Median $1.00 Typical High $1.51 | Professional | RR · Rental | $1.00 | $1.00 | $1.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.59 Median $7.59 Typical High $10.00 | Professional | UE · Used equipment | $7.59 | $7.59 | $10.00 |
Where Wisconsin sits
The same service costs 2.8 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· 5th of 51
$21.38
HI $27.54CT $10.00
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.