How much rates vary
Facilitymedian $10 · 10th to 90th $6 to $29Professionalmedian $10 · 10th to 90th $5 to $16
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 $7.41 Median $7.41 Typical High $7.41 | Facility | None | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $16.98 | Professional | None | $7.41 | $7.41 | $16.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.47 Median $11.48 Typical High $17.38 | Facility | None | $10.47 | $11.48 | $17.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $10.47 Typical High $13.18 | Professional | None | $5.13 | $10.47 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $28.84 Typical High $44.67 | Facility | None | $6.17 | $28.84 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $7.08 Typical High $19.95 | Professional | None | $5.25 | $7.08 | $19.95 |
DeanCare Setting Facility Modifier None Typical Low $2.82 Median $10.23 Typical High $11.75 | Facility | None | $2.82 | $10.23 | $11.75 |
DeanCare Setting Professional Modifier None Typical Low $10.23 Median $20.89 Typical High $21.88 | Professional | None | $10.23 | $20.89 | $21.88 |
Medica Setting Facility Modifier None Typical Low $5.01 Median $10.23 Typical High $79.43 | Facility | None | $5.01 | $10.23 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.37 Median $6.17 Typical High $51.29 | Professional | None | $4.37 | $6.17 | $51.29 |
Network Health Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Network Health Setting Professional Modifier None Typical Low $7.41 Median $9.77 Typical High $17.78 | Professional | None | $7.41 | $9.77 | $17.78 |
Prevea360 Setting Facility Modifier None Typical Low $2.82 Median $10.23 Typical High $11.75 | Facility | None | $2.82 | $10.23 | $11.75 |
Prevea360 Setting Professional Modifier None Typical Low $5.62 Median $9.77 Typical High $10.23 | Professional | None | $5.62 | $9.77 | $10.23 |
Quartz Setting Professional Modifier None Typical Low $9.55 Median $15.14 Typical High $21.88 | Professional | None | $9.55 | $15.14 | $21.88 |
Quartz Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.61 | Facility | None | $6.17 | $6.17 | $6.61 |
Quartz Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.61 | Professional | None | $5.25 | $5.25 | $6.61 |
Security Health Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Security Health Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $13.49 | Professional | None | $10.47 | $10.47 | $13.49 |
United Setting Professional Modifier None Typical Low $3.39 Median $5.13 Typical High $8.91 | Professional | None | $3.39 | $5.13 | $8.91 |
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 $1.12 Median $1.12 Typical High $2.51 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.74 Median $0.74 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.74 | $0.74 | $1.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.48 Median $0.48 Typical High $0.71 | Professional | RR · Rental | $0.48 | $0.48 | $0.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.63 Median $3.63 Typical High $5.13 | Professional | UE · Used equipment | $3.63 | $3.63 | $5.13 |
Where Wisconsin sits
The same service costs 2.1 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· 7th of 51
$9.77
HI $10.72CT $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.