How much rates vary
Facilitymedian $25 · 10th to 90th $16 to $66Professionalmedian $21 · 10th to 90th $11 to $33
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 $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $28.84 | Professional | None | $17.38 | $17.38 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $24.55 Median $26.92 Typical High $40.74 | Facility | None | $24.55 | $26.92 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $24.55 Typical High $30.20 | Professional | None | $12.02 | $24.55 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $66.07 Typical High $102.33 | Facility | None | $15.85 | $66.07 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $13.49 Typical High $40.74 | Professional | None | $10.00 | $13.49 | $40.74 |
DeanCare Setting Facility Modifier None Typical Low $6.61 Median $23.99 Typical High $27.54 | Facility | None | $6.61 | $23.99 | $27.54 |
DeanCare Setting Professional Modifier None Typical Low $22.39 Median $24.55 Typical High $28.84 | Professional | None | $22.39 | $24.55 | $28.84 |
Medica Setting Facility Modifier None Typical Low $11.75 Median $23.99 Typical High $112.20 | Facility | None | $11.75 | $23.99 | $112.20 |
Medica Setting Professional Modifier None Typical Low $10.23 Median $14.45 Typical High $120.23 | Professional | None | $10.23 | $14.45 | $120.23 |
Network Health Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Network Health Setting Professional Modifier None Typical Low $17.38 Median $22.39 Typical High $41.69 | Professional | None | $17.38 | $22.39 | $41.69 |
Prevea360 Setting Facility Modifier None Typical Low $6.61 Median $23.99 Typical High $27.54 | Facility | None | $6.61 | $23.99 | $27.54 |
Prevea360 Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $23.99 | Professional | None | $13.80 | $13.80 | $23.99 |
Quartz Setting Professional Modifier None Typical Low $22.39 Median $32.36 Typical High $51.29 | Professional | None | $22.39 | $32.36 | $51.29 |
Quartz Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $16.98 | Facility | None | $15.85 | $15.85 | $16.98 |
Quartz Setting Professional Modifier None Typical Low $10.00 Median $13.49 Typical High $15.85 | Professional | None | $10.00 | $13.49 | $15.85 |
Security Health Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Security Health Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $31.62 | Professional | None | $24.55 | $24.55 | $31.62 |
United Setting Professional Modifier None Typical Low $7.94 Median $12.02 Typical High $20.42 | Professional | None | $7.94 | $12.02 | $20.42 |
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 $2.57 Median $2.57 Typical High $4.37 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $2.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.20 Median $1.20 Typical High $1.70 | Professional | RR · Rental | $1.20 | $1.20 | $1.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.12 Median $9.12 Typical High $12.88 | Professional | UE · Used equipment | $9.12 | $9.12 | $12.88 |
Where Wisconsin sits
The same service costs 2.3 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· 6th of 51
$22.39
HI $27.54CT $12.02
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.