How much rates vary
Facilitymedian $10 · 10th to 90th $6 to $27Professionalmedian $9 · 10th to 90th $4 to $15
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 $6.92 Median $6.92 Typical High $6.92 | Facility | None | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $15.85 | Professional | None | $6.92 | $6.92 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.77 Median $10.96 Typical High $16.22 | Facility | None | $9.77 | $10.96 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.07 Median $9.77 Typical High $12.88 | Professional | None | $4.07 | $9.77 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $26.92 Typical High $41.69 | Facility | None | $5.75 | $26.92 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $7.24 Typical High $18.62 | Professional | None | $4.90 | $7.24 | $18.62 |
DeanCare Setting Facility Modifier None Typical Low $2.63 Median $9.77 Typical High $11.22 | Facility | None | $2.63 | $9.77 | $11.22 |
DeanCare Setting Professional Modifier None Typical Low $9.77 Median $18.62 Typical High $19.95 | Professional | None | $9.77 | $18.62 | $19.95 |
Medica Setting Facility Modifier None Typical Low $4.68 Median $9.77 Typical High $79.43 | Facility | None | $4.68 | $9.77 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.07 Median $6.17 Typical High $61.66 | Professional | None | $4.07 | $6.17 | $61.66 |
Network Health Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Network Health Setting Professional Modifier None Typical Low $6.92 Median $9.12 Typical High $16.98 | Professional | None | $6.92 | $9.12 | $16.98 |
Prevea360 Setting Facility Modifier None Typical Low $2.63 Median $9.77 Typical High $11.22 | Facility | None | $2.63 | $9.77 | $11.22 |
Prevea360 Setting Professional Modifier None Typical Low $5.13 Median $8.51 Typical High $9.77 | Professional | None | $5.13 | $8.51 | $9.77 |
Quartz Setting Professional Modifier None Typical Low $9.33 Median $13.80 Typical High $21.38 | Professional | None | $9.33 | $13.80 | $21.38 |
Quartz Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $7.24 | Facility | None | $5.75 | $5.75 | $7.24 |
Quartz Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $7.24 | Professional | None | $4.90 | $4.90 | $7.24 |
Security Health Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Security Health Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $12.88 | Professional | None | $9.77 | $9.77 | $12.88 |
United Setting Professional Modifier None Typical Low $3.24 Median $4.79 Typical High $8.91 | Professional | None | $3.24 | $4.79 | $8.91 |
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 $3.47 Median $3.47 Typical High $7.94 | Professional | 52 · Reduced service | $3.47 | $3.47 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.38 Typical High $3.24 | Professional | 53 · Discontinued | $1.38 | $1.38 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.05 Median $1.05 Typical High $2.40 | Professional | 55 · Aftercare only | $1.05 | $1.05 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.71 Typical High $1.58 | Professional | 56 · Pre-op care only | $0.71 | $0.71 | $1.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.41 Median $0.41 Typical High $0.65 | Professional | RR · Rental | $0.41 | $0.41 | $0.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.09 Median $3.09 Typical High $4.07 | Professional | UE · Used equipment | $3.09 | $3.09 | $4.07 |
Where Wisconsin sits
The same service costs 2.5 times more in Montana 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· 3rd of 51
$9.12
MT $10.23NH $4.07
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.