How much rates vary
Facilitymedian $5 · 10th to 90th $4 to $14Professionalmedian $5 · 10th to 90th $3 to $8
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 $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $10.00 | Professional | None | $3.80 | $3.80 | $10.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.37 Median $5.89 Typical High $8.91 | Facility | None | $5.37 | $5.89 | $8.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $5.37 Typical High $6.76 | Professional | None | $2.63 | $5.37 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $14.45 Typical High $22.39 | Facility | None | $3.55 | $14.45 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $3.80 Typical High $10.23 | Professional | None | $2.95 | $3.80 | $10.23 |
DeanCare Setting Facility Modifier None Typical Low $1.45 Median $5.25 Typical High $6.03 | Facility | None | $1.45 | $5.25 | $6.03 |
DeanCare Setting Professional Modifier None Typical Low $5.89 Median $10.47 Typical High $10.96 | Professional | None | $5.89 | $10.47 | $10.96 |
Medica Setting Facility Modifier None Typical Low $2.57 Median $5.25 Typical High $79.43 | Facility | None | $2.57 | $5.25 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.24 Median $3.16 Typical High $26.30 | Professional | None | $2.24 | $3.16 | $26.30 |
Network Health Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Network Health Setting Professional Modifier None Typical Low $3.80 Median $4.90 Typical High $9.12 | Professional | None | $3.80 | $4.90 | $9.12 |
Prevea360 Setting Facility Modifier None Typical Low $1.45 Median $5.25 Typical High $6.03 | Facility | None | $1.45 | $5.25 | $6.03 |
Prevea360 Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $5.25 | Professional | None | $3.02 | $3.02 | $5.25 |
Quartz Setting Professional Modifier None Typical Low $4.79 Median $7.08 Typical High $10.96 | Professional | None | $4.79 | $7.08 | $10.96 |
Quartz Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Quartz Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.72 | Professional | None | $2.95 | $2.95 | $3.72 |
Security Health Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Security Health Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $6.92 | Professional | None | $5.37 | $5.37 | $6.92 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.63 Typical High $4.47 | Professional | None | $1.74 | $2.63 | $4.47 |
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 $1.91 Median $1.91 Typical High $5.01 | Professional | 52 · Reduced service | $1.91 | $1.91 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.76 Typical High $2.00 | Professional | 53 · Discontinued | $0.76 | $0.76 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $1.51 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.38 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.38 | $0.38 | $1.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.26 Median $0.26 Typical High $0.37 | Professional | RR · Rental | $0.26 | $0.26 | $0.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.95 Median $2.63 Typical High $2.63 | Professional | UE · Used equipment | $1.95 | $2.63 | $2.63 |
Where Wisconsin sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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
$5.01
KS $6.76NH $2.63
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.