How much rates vary
Facilitymedian $40 · 10th to 90th $26 to $110Professionalmedian $36 · 10th to 90th $18 to $60
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 $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $79.43 | Professional | None | $28.18 | $28.18 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $39.81 Median $44.67 Typical High $66.07 | Facility | None | $39.81 | $44.67 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $39.81 Typical High $52.48 | Professional | None | $19.95 | $39.81 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $109.65 Typical High $169.82 | Facility | None | $26.30 | $109.65 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $67.61 | Professional | None | $16.22 | $22.39 | $67.61 |
DeanCare Setting Facility Modifier None Typical Low $10.72 Median $39.81 Typical High $45.71 | Facility | None | $10.72 | $39.81 | $45.71 |
DeanCare Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $35.48 | Professional | None | $26.30 | $28.84 | $35.48 |
Medica Setting Facility Modifier None Typical Low $19.05 Median $39.81 Typical High $186.21 | Facility | None | $19.05 | $39.81 | $186.21 |
Medica Setting Professional Modifier None Typical Low $16.60 Median $23.44 Typical High $194.98 | Professional | None | $16.60 | $23.44 | $194.98 |
Network Health Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Network Health Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $69.18 | Professional | None | $28.18 | $37.15 | $69.18 |
Prevea360 Setting Facility Modifier None Typical Low $10.72 Median $39.81 Typical High $45.71 | Facility | None | $10.72 | $39.81 | $45.71 |
Prevea360 Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $39.81 | Professional | None | $22.39 | $22.39 | $39.81 |
Quartz Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $85.11 | Professional | None | $37.15 | $53.70 | $85.11 |
Quartz Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $28.18 | Facility | None | $26.30 | $26.30 | $28.18 |
Quartz Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $26.30 | Professional | None | $16.22 | $22.39 | $26.30 |
Security Health Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Security Health Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | None | $39.81 | $39.81 | $52.48 |
United Setting Professional Modifier None Typical Low $13.18 Median $19.50 Typical High $33.88 | Professional | None | $13.18 | $19.50 | $33.88 |
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 $4.27 Median $4.27 Typical High $11.75 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $7.94 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $7.94 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.95 Median $1.95 Typical High $2.82 | Professional | RR · Rental | $1.95 | $1.95 | $2.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.79 Median $14.79 Typical High $15.85 | Professional | UE · Used equipment | $14.79 | $14.79 | $15.85 |
Where Wisconsin sits
The same service costs 3.0 times more in Hawaii than in Kansas. 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
$37.15
HI $45.71KS $15.49
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.