How much rates vary
Facilitymedian $10 · 10th to 90th $6 to $27Professionalmedian $9 · 10th to 90th $5 to $15
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 $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $12.02 | Professional | None | $7.08 | $7.08 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.00 Median $10.96 Typical High $16.60 | Facility | None | $10.00 | $10.96 | $16.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.80 Median $10.00 Typical High $12.88 | Professional | None | $3.80 | $10.00 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $26.92 Typical High $41.69 | Facility | None | $5.89 | $26.92 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $7.24 Typical High $19.05 | Professional | None | $5.01 | $7.24 | $19.05 |
DeanCare Setting Facility Modifier None Typical Low $2.69 Median $9.77 Typical High $10.23 | Facility | None | $2.69 | $9.77 | $10.23 |
DeanCare Setting Professional Modifier None Typical Low $12.59 Median $13.80 Typical High $14.45 | Professional | None | $12.59 | $13.80 | $14.45 |
Medica Setting Facility Modifier None Typical Low $3.80 Median $9.77 Typical High $79.43 | Facility | None | $3.80 | $9.77 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.47 Median $6.31 Typical High $48.98 | Professional | None | $4.47 | $6.31 | $48.98 |
Network Health Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Network Health Setting Professional Modifier None Typical Low $7.08 Median $9.12 Typical High $16.98 | Professional | None | $7.08 | $9.12 | $16.98 |
Prevea360 Setting Facility Modifier None Typical Low $2.69 Median $9.77 Typical High $10.23 | Facility | None | $2.69 | $9.77 | $10.23 |
Prevea360 Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $9.77 | Professional | None | $5.62 | $5.62 | $9.77 |
Quartz Setting Professional Modifier None Typical Low $9.33 Median $14.79 Typical High $21.38 | Professional | None | $9.33 | $14.79 | $21.38 |
Quartz Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $7.08 | Facility | None | $5.89 | $5.89 | $7.08 |
Quartz Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $6.92 | Professional | None | $5.01 | $5.01 | $6.92 |
Security Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Security Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $12.88 | Professional | None | $10.00 | $10.00 | $12.88 |
United Setting Professional Modifier None Typical Low $3.24 Median $4.90 Typical High $9.12 | Professional | None | $3.24 | $4.90 | $9.12 |
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 $1.07 Median $1.07 Typical High $1.82 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.71 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.71 | $0.71 | $1.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.38 Median $0.38 Typical High $0.71 | Professional | RR · Rental | $0.38 | $0.38 | $0.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.69 Median $2.69 Typical High $2.88 | Professional | UE · Used equipment | $2.69 | $2.69 | $2.88 |
Where Wisconsin sits
The same service costs 2.4 times more in Kansas 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· 9th of 51
$9.33
KS $10.96CT $4.57
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.