How much rates vary
Facilitymedian $12 · 10th to 90th $8 to $32Professionalmedian $11 · 10th to 90th $6 to $18
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 $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $26.92 | Professional | None | $8.32 | $8.32 | $26.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.75 Median $12.88 Typical High $19.50 | Facility | None | $11.75 | $12.88 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $11.75 Typical High $14.45 | Professional | None | $5.75 | $11.75 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $32.36 Typical High $50.12 | Facility | None | $7.59 | $32.36 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $8.13 Typical High $22.39 | Professional | None | $6.46 | $8.13 | $22.39 |
DeanCare Setting Facility Modifier None Typical Low $3.16 Median $11.48 Typical High $13.18 | Facility | None | $3.16 | $11.48 | $13.18 |
DeanCare Setting Professional Modifier None Typical Low $12.88 Median $14.45 Typical High $15.49 | Professional | None | $12.88 | $14.45 | $15.49 |
Medica Setting Facility Modifier None Typical Low $5.62 Median $11.48 Typical High $79.43 | Facility | None | $5.62 | $11.48 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.90 Median $6.92 Typical High $57.54 | Professional | None | $4.90 | $6.92 | $57.54 |
Network Health Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Network Health Setting Professional Modifier None Typical Low $8.32 Median $10.72 Typical High $19.95 | Professional | None | $8.32 | $10.72 | $19.95 |
Prevea360 Setting Facility Modifier None Typical Low $3.16 Median $11.48 Typical High $13.18 | Facility | None | $3.16 | $11.48 | $13.18 |
Prevea360 Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $11.48 | Professional | None | $6.61 | $6.61 | $11.48 |
Quartz Setting Professional Modifier None Typical Low $10.72 Median $15.49 Typical High $24.55 | Professional | None | $10.72 | $15.49 | $24.55 |
Quartz Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
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 $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
Security Health Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $15.14 | Professional | None | $11.75 | $11.75 | $15.14 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $9.77 | Professional | None | $3.80 | $5.75 | $9.77 |
6 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 52 · Reduced service Typical Low $4.17 Median $4.17 Typical High $13.49 | Professional | 52 · Reduced service | $4.17 | $4.17 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.66 Typical High $5.37 | Professional | 53 · Discontinued | $1.66 | $1.66 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.26 Typical High $4.07 | Professional | 55 · Aftercare only | $1.26 | $1.26 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.83 Typical High $2.69 | Professional | 56 · Pre-op care only | $0.83 | $0.83 | $2.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.58 Median $0.58 Typical High $0.81 | Professional | RR · Rental | $0.58 | $0.58 | $0.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.37 Median $4.68 Typical High $6.17 | Professional | UE · Used equipment | $4.37 | $4.68 | $6.17 |
Where Wisconsin sits
The same service costs 2.1 times more in Idaho 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· 8th of 51
$10.96
ID $12.30CT $5.75
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.