How much rates vary
Facilitymedian $6 · 10th to 90th $4 to $16Professionalmedian $5 · 10th to 90th $3 to $9
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 $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $19.05 | Professional | None | $4.27 | $4.27 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.03 Median $6.61 Typical High $9.77 | Facility | None | $6.03 | $6.61 | $9.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $6.03 Typical High $7.41 | Professional | None | $2.95 | $6.03 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $16.22 Typical High $25.12 | Facility | None | $3.80 | $16.22 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $10.00 | Professional | None | $2.45 | $3.24 | $10.00 |
DeanCare Setting Facility Modifier None Typical Low $1.58 Median $5.89 Typical High $6.76 | Facility | None | $1.58 | $5.89 | $6.76 |
DeanCare Setting Professional Modifier None Typical Low $9.33 Median $10.00 Typical High $10.96 | Professional | None | $9.33 | $10.00 | $10.96 |
Medica Setting Facility Modifier None Typical Low $2.82 Median $5.89 Typical High $79.43 | Facility | None | $2.82 | $5.89 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.45 Median $3.55 Typical High $29.51 | Professional | None | $2.45 | $3.55 | $29.51 |
Network Health Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Network Health Setting Professional Modifier None Typical Low $4.27 Median $5.50 Typical High $10.23 | Professional | None | $4.27 | $5.50 | $10.23 |
Prevea360 Setting Facility Modifier None Typical Low $1.58 Median $5.89 Typical High $6.76 | Facility | None | $1.58 | $5.89 | $6.76 |
Prevea360 Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $5.89 | Professional | None | $3.31 | $3.31 | $5.89 |
Quartz Setting Professional Modifier None Typical Low $5.62 Median $8.32 Typical High $12.88 | Professional | None | $5.62 | $8.32 | $12.88 |
Quartz Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $4.07 | Facility | None | $3.80 | $3.80 | $4.07 |
Quartz Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $3.80 | Professional | None | $2.45 | $3.24 | $3.80 |
Security Health Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Security Health Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.76 | Professional | None | $6.03 | $6.03 | $7.76 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.95 Typical High $5.01 | Professional | None | $1.95 | $2.95 | $5.01 |
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 $0.63 Median $0.63 Typical High $2.82 | Professional | 55 · Aftercare only | $0.63 | $0.63 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $1.91 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $1.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.28 Median $0.28 Typical High $0.42 | Professional | RR · Rental | $0.28 | $0.28 | $0.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.19 Median $2.19 Typical High $3.16 | Professional | UE · Used equipment | $2.19 | $2.19 | $3.16 |
Where Wisconsin sits
The same service costs 3.2 times more in Kansas than in New Hampshire. 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· 8th of 51
$5.62
KS $9.33NH $2.95
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.