How much rates vary
Facilitymedian $14 · 10th to 90th $8 to $39Professionalmedian $13 · 10th to 90th $7 to $21
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 $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $23.99 | Professional | None | $10.00 | $10.00 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.13 Median $15.49 Typical High $23.44 | Facility | None | $14.13 | $15.49 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $14.13 Typical High $18.20 | Professional | None | $7.24 | $14.13 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $38.90 Typical High $58.88 | Facility | None | $8.32 | $38.90 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $9.77 Typical High $26.92 | Professional | None | $7.08 | $9.77 | $26.92 |
DeanCare Setting Facility Modifier None Typical Low $3.80 Median $13.80 Typical High $15.85 | Facility | None | $3.80 | $13.80 | $15.85 |
DeanCare Setting Professional Modifier None Typical Low $16.60 Median $18.20 Typical High $21.38 | Professional | None | $16.60 | $18.20 | $21.38 |
Medica Setting Facility Modifier None Typical Low $6.76 Median $13.80 Typical High $79.43 | Facility | None | $6.76 | $13.80 | $79.43 |
Medica Setting Professional Modifier None Typical Low $5.89 Median $8.32 Typical High $69.18 | Professional | None | $5.89 | $8.32 | $69.18 |
Network Health Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Network Health Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $23.99 | Professional | None | $10.00 | $12.88 | $23.99 |
Prevea360 Setting Facility Modifier None Typical Low $3.80 Median $13.80 Typical High $15.85 | Facility | None | $3.80 | $13.80 | $15.85 |
Prevea360 Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $13.80 | Professional | None | $7.94 | $7.94 | $13.80 |
Quartz Setting Professional Modifier None Typical Low $12.88 Median $18.62 Typical High $29.51 | Professional | None | $12.88 | $18.62 | $29.51 |
Quartz Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Quartz Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $8.91 | Professional | None | $7.08 | $7.08 | $8.91 |
Security Health Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Security Health Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $18.20 | Professional | None | $14.13 | $14.13 | $18.20 |
United Setting Professional Modifier None Typical Low $4.57 Median $6.92 Typical High $11.75 | Professional | None | $4.57 | $6.92 | $11.75 |
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 $1.48 Median $1.48 Typical High $3.63 | Professional | 55 · Aftercare only | $1.48 | $1.48 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $2.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.69 Median $0.69 Typical High $0.98 | Professional | RR · Rental | $0.69 | $0.69 | $0.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.13 Median $5.62 Typical High $7.24 | Professional | UE · Used equipment | $5.13 | $5.62 | $7.24 |
Where Wisconsin sits
The same service costs 2.1 times more in Idaho than in Delaware. 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
$13.18
ID $14.79DE $7.08
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.