How much rates vary
Facilitymedian $9 · 10th to 90th $5 to $23Professionalmedian $8 · 10th to 90th $4 to $13
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 $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $16.98 | Professional | None | $6.03 | $6.03 | $16.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.51 Median $9.33 Typical High $14.13 | Facility | None | $8.51 | $9.33 | $14.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.47 Median $8.51 Typical High $10.96 | Professional | None | $4.47 | $8.51 | $10.96 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $23.44 Typical High $36.31 | Facility | None | $5.01 | $23.44 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $5.89 Typical High $16.22 | Professional | None | $4.27 | $5.89 | $16.22 |
DeanCare Setting Facility Modifier None Typical Low $2.29 Median $8.32 Typical High $9.55 | Facility | None | $2.29 | $8.32 | $9.55 |
DeanCare Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $13.80 | Professional | None | $10.96 | $12.88 | $13.80 |
Medica Setting Facility Modifier None Typical Low $4.07 Median $8.32 Typical High $79.43 | Facility | None | $4.07 | $8.32 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.55 Median $5.01 Typical High $41.69 | Professional | None | $3.55 | $5.01 | $41.69 |
Network Health Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Network Health Setting Professional Modifier None Typical Low $6.03 Median $7.94 Typical High $14.79 | Professional | None | $6.03 | $7.94 | $14.79 |
Prevea360 Setting Facility Modifier None Typical Low $2.29 Median $8.32 Typical High $9.55 | Facility | None | $2.29 | $8.32 | $9.55 |
Prevea360 Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $8.32 | Professional | None | $4.79 | $4.79 | $8.32 |
Quartz Setting Professional Modifier None Typical Low $7.76 Median $11.22 Typical High $17.78 | Professional | None | $7.76 | $11.22 | $17.78 |
Quartz Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.37 | Facility | None | $5.01 | $5.01 | $5.37 |
Quartz Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.37 | Professional | None | $4.27 | $4.27 | $5.37 |
Security Health Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Security Health Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $11.22 | Professional | None | $8.51 | $8.51 | $11.22 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.17 Typical High $7.24 | Professional | None | $2.75 | $4.17 | $7.24 |
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 $0.89 Median $0.89 Typical High $2.51 | Professional | 55 · Aftercare only | $0.89 | $0.89 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.60 Median $0.60 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.60 | $0.60 | $1.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.42 Median $0.42 Typical High $0.60 | Professional | RR · Rental | $0.42 | $0.42 | $0.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.16 Median $3.16 Typical High $4.47 | Professional | UE · Used equipment | $3.16 | $3.16 | $4.47 |
Where Wisconsin sits
The same service costs 2.1 times more in Hawaii 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· 9th of 51
$7.94
HI $8.91DE $4.27
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.