How much rates vary
Facilitymedian $8 · 10th to 90th $5 to $22Professionalmedian $7 · 10th to 90th $4 to $12
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 $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $5.50 Typical High $10.00 | Professional | None | $4.27 | $5.50 | $10.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.76 Median $8.51 Typical High $12.88 | Facility | None | $7.76 | $8.51 | $12.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $7.76 Typical High $9.77 | Professional | None | $3.47 | $7.76 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $21.88 Typical High $33.11 | Facility | None | $5.37 | $21.88 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $6.17 Typical High $14.79 | Professional | None | $4.57 | $6.17 | $14.79 |
DeanCare Setting Facility Modifier None Typical Low $2.45 Median $7.59 Typical High $7.94 | Facility | None | $2.45 | $7.59 | $7.94 |
DeanCare Setting Professional Modifier None Typical Low $8.32 Median $12.88 Typical High $13.49 | Professional | None | $8.32 | $12.88 | $13.49 |
Medica Setting Facility Modifier None Typical Low $3.63 Median $7.59 Typical High $79.43 | Facility | None | $3.63 | $7.59 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.55 Median $5.13 Typical High $61.66 | Professional | None | $3.55 | $5.13 | $61.66 |
Network Health Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Network Health Setting Professional Modifier None Typical Low $5.50 Median $7.24 Typical High $13.49 | Professional | None | $5.50 | $7.24 | $13.49 |
Prevea360 Setting Facility Modifier None Typical Low $2.45 Median $7.59 Typical High $7.94 | Facility | None | $2.45 | $7.59 | $7.94 |
Prevea360 Setting Professional Modifier None Typical Low $4.37 Median $7.59 Typical High $8.91 | Professional | None | $4.37 | $7.59 | $8.91 |
Quartz Setting Professional Modifier None Typical Low $7.76 Median $11.75 Typical High $19.50 | Professional | None | $7.76 | $11.75 | $19.50 |
Quartz Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.62 | Facility | None | $5.37 | $5.37 | $5.62 |
Quartz Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $5.75 | Professional | None | $4.57 | $4.57 | $5.75 |
Security Health Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Security Health Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $10.00 | Professional | None | $7.76 | $7.76 | $10.00 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.47 Typical High $7.24 | Professional | None | $2.95 | $4.47 | $7.24 |
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 $0.81 Median $0.81 Typical High $1.51 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $1.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.34 Typical High $0.60 | Professional | RR · Rental | $0.34 | $0.34 | $0.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.82 Typical High $3.47 | Professional | UE · Used equipment | $2.57 | $2.82 | $3.47 |
Where Wisconsin sits
The same service costs 4.2 times more in Hawaii than in Kentucky. 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· 14th of 51
$7.24
HI $15.85KY $3.80
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.