How much rates vary
Facilitymedian $13 · 10th to 90th $6 to $35Professionalmedian $12 · 10th to 90th $5 to $19
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 $8.91 Median $8.91 Typical High $8.91 | Facility | None | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $22.91 | Professional | None | $8.91 | $8.91 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.59 Median $14.13 Typical High $20.89 | Facility | None | $12.59 | $14.13 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.37 Median $12.59 Typical High $15.85 | Professional | None | $5.37 | $12.59 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $35.48 Typical High $53.70 | Facility | None | $5.89 | $35.48 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $21.38 | Professional | None | $5.01 | $5.13 | $21.38 |
DeanCare Setting Facility Modifier None Typical Low $3.39 Median $12.59 Typical High $14.45 | Facility | None | $3.39 | $12.59 | $14.45 |
DeanCare Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $19.95 | Professional | None | $17.38 | $18.62 | $19.95 |
Medica Setting Facility Modifier None Typical Low $6.03 Median $12.59 Typical High $79.43 | Facility | None | $6.03 | $12.59 | $79.43 |
Medica Setting Professional Modifier None Typical Low $5.62 Median $7.94 Typical High $61.66 | Professional | None | $5.62 | $7.94 | $61.66 |
Network Health Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Network Health Setting Professional Modifier None Typical Low $8.91 Median $11.75 Typical High $21.88 | Professional | None | $8.91 | $11.75 | $21.88 |
Prevea360 Setting Facility Modifier None Typical Low $3.39 Median $12.59 Typical High $14.45 | Facility | None | $3.39 | $12.59 | $14.45 |
Prevea360 Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $12.59 | Professional | None | $7.08 | $7.08 | $12.59 |
Quartz Setting Professional Modifier None Typical Low $11.75 Median $16.98 Typical High $26.92 | Professional | None | $11.75 | $16.98 | $26.92 |
Quartz Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $6.31 | Facility | None | $5.89 | $5.89 | $6.31 |
Quartz Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $5.89 | Professional | None | $5.01 | $5.13 | $5.89 |
Security Health Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Security Health Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $16.60 | Professional | None | $12.59 | $12.59 | $16.60 |
United Setting Professional Modifier None Typical Low $4.17 Median $6.17 Typical High $11.48 | Professional | None | $4.17 | $6.17 | $11.48 |
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 $1.35 Median $1.35 Typical High $3.47 | Professional | 55 · Aftercare only | $1.35 | $1.35 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $0.89 Typical High $2.29 | Professional | 56 · Pre-op care only | $0.89 | $0.89 | $2.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.54 Median $0.54 Typical High $0.83 | Professional | RR · Rental | $0.54 | $0.54 | $0.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.98 Median $3.98 Typical High $5.37 | Professional | UE · Used equipment | $3.98 | $3.98 | $5.37 |
Where Wisconsin sits
The same service costs 2.7 times more in Hawaii than in Vermont. 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· 4th of 51
$11.75
HI $13.80VT $5.13
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.