How much rates vary
Facilitymedian $13 · 10th to 90th $8 to $35Professionalmedian $12 · 10th to 90th $6 to $20
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 $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $23.99 | Professional | None | $9.12 | $9.12 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.88 Median $14.13 Typical High $21.38 | Facility | None | $12.88 | $14.13 | $21.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $12.88 Typical High $16.22 | Professional | None | $6.76 | $12.88 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $35.48 Typical High $53.70 | Facility | None | $7.59 | $35.48 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $8.91 Typical High $24.55 | Professional | None | $6.46 | $8.91 | $24.55 |
DeanCare Setting Facility Modifier None Typical Low $3.47 Median $12.59 Typical High $14.45 | Facility | None | $3.47 | $12.59 | $14.45 |
DeanCare Setting Professional Modifier None Typical Low $16.60 Median $19.95 Typical High $21.38 | Professional | None | $16.60 | $19.95 | $21.38 |
Medica Setting Facility Modifier None Typical Low $6.17 Median $12.59 Typical High $79.43 | Facility | None | $6.17 | $12.59 | $79.43 |
Medica Setting Professional Modifier None Typical Low $5.37 Median $7.59 Typical High $63.10 | Professional | None | $5.37 | $7.59 | $63.10 |
Network Health Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Network Health Setting Professional Modifier None Typical Low $9.12 Median $11.75 Typical High $21.88 | Professional | None | $9.12 | $11.75 | $21.88 |
Prevea360 Setting Facility Modifier None Typical Low $3.47 Median $12.59 Typical High $14.45 | Facility | None | $3.47 | $12.59 | $14.45 |
Prevea360 Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $12.59 | Professional | None | $7.24 | $7.24 | $12.59 |
Quartz Setting Professional Modifier None Typical Low $11.75 Median $16.98 Typical High $26.92 | Professional | None | $11.75 | $16.98 | $26.92 |
Quartz Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.94 | Facility | None | $7.59 | $7.59 | $7.94 |
Quartz Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $8.13 | Professional | None | $6.46 | $6.46 | $8.13 |
Security Health Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Security Health Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $16.60 | Professional | None | $12.88 | $12.88 | $16.60 |
United Setting Professional Modifier None Typical Low $4.17 Median $6.31 Typical High $10.96 | Professional | None | $4.17 | $6.31 | $10.96 |
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 $1.35 Median $1.35 Typical High $3.63 | Professional | 55 · Aftercare only | $1.35 | $1.35 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.91 Typical High $2.40 | Professional | 56 · Pre-op care only | $0.91 | $0.91 | $2.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.63 Median $0.63 Typical High $0.89 | Professional | RR · Rental | $0.63 | $0.63 | $0.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.79 Median $5.13 Typical High $6.76 | Professional | UE · Used equipment | $4.79 | $5.13 | $6.76 |
Where Wisconsin sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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
$12.02
ID $13.49NJ $6.46
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.