How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $4Professionalmedian $2 · 10th to 90th $1 to $3
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 $1.23 Median $1.23 Typical High $1.23 | Facility | None | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $15.14 | Professional | None | $1.23 | $1.23 | $15.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.74 Median $1.91 Typical High $2.82 | Facility | None | $1.74 | $1.91 | $2.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.95 | Professional | None | $1.62 | $1.62 | $1.95 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $5.13 Typical High $7.59 | Facility | None | $4.47 | $5.13 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.86 Typical High $2.88 | Professional | None | $1.02 | $1.86 | $2.88 |
DeanCare Setting Facility Modifier None Typical Low $0.98 Median $1.70 Typical High $1.82 | Facility | None | $0.98 | $1.70 | $1.82 |
DeanCare Setting Professional Modifier None Typical Low $1.55 Median $3.47 Typical High $4.07 | Professional | None | $1.55 | $3.47 | $4.07 |
Medica Setting Facility Modifier None Typical Low $0.98 Median $1.70 Typical High $3.47 | Facility | None | $0.98 | $1.70 | $3.47 |
Medica Setting Professional Modifier None Typical Low $0.79 Median $1.12 Typical High $10.00 | Professional | None | $0.79 | $1.12 | $10.00 |
Network Health Setting Facility Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Facility | None | $2.75 | $2.75 | $2.75 |
Network Health Setting Professional Modifier None Typical Low $1.48 Median $1.58 Typical High $2.88 | Professional | None | $1.48 | $1.58 | $2.88 |
Prevea360 Setting Facility Modifier None Typical Low $0.98 Median $1.70 Typical High $1.82 | Facility | None | $0.98 | $1.70 | $1.82 |
Prevea360 Setting Professional Modifier None Typical Low $1.00 Median $1.70 Typical High $1.70 | Professional | None | $1.00 | $1.70 | $1.70 |
Quartz Setting Professional Modifier None Typical Low $1.86 Median $2.63 Typical High $4.27 | Professional | None | $1.86 | $2.63 | $4.27 |
Quartz Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Security Health Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Security Health Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.24 | Professional | None | $1.74 | $1.74 | $2.24 |
United Setting Professional Modifier None Typical Low $0.66 Median $0.85 Typical High $1.58 | Professional | None | $0.66 | $0.85 | $1.58 |
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 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $2.24 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $1.51 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $1.51 |
DeanCare Setting Professional Modifier 52 · Reduced service Typical Low $1.55 Median $3.72 Typical High $4.07 | Professional | 52 · Reduced service | $1.55 | $3.72 | $4.07 |
DeanCare Setting Professional Modifier 59 · Distinct service Typical Low $1.55 Median $3.72 Typical High $4.07 | Professional | 59 · Distinct service | $1.55 | $3.72 | $4.07 |
DeanCare Setting Professional Modifier RR · Rental Typical Low $1.55 Median $3.72 Typical High $4.07 | Professional | RR · Rental | $1.55 | $3.72 | $4.07 |
DeanCare Setting Professional Modifier UE · Used equipment Typical Low $1.55 Median $3.72 Typical High $4.07 | Professional | UE · Used equipment | $1.55 | $3.72 | $4.07 |
Where Wisconsin sits
The same service costs 3.1 times more in Hawaii than in Utah. 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· 15th of 51
$1.62
HI $2.63UT $0.85
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.