How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $7Professionalmedian $2 · 10th to 90th $1 to $4
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 $1.82 Median $1.82 Typical High $1.82 | Facility | None | $1.82 | $1.82 | $1.82 |
Aetna Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $5.01 | Professional | None | $1.82 | $1.82 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.57 Median $2.82 Typical High $4.27 | Facility | None | $2.57 | $2.82 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.32 Median $2.57 Typical High $3.24 | Professional | None | $1.32 | $2.57 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $7.24 Typical High $10.96 | Facility | None | $1.51 | $7.24 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.78 Typical High $4.79 | Professional | None | $1.29 | $1.78 | $4.79 |
DeanCare Setting Facility Modifier None Typical Low $0.68 Median $2.51 Typical High $2.88 | Facility | None | $0.68 | $2.51 | $2.88 |
DeanCare Setting Professional Modifier None Typical Low $3.47 Median $3.72 Typical High $4.07 | Professional | None | $3.47 | $3.72 | $4.07 |
Medica Setting Facility Modifier None Typical Low $1.23 Median $2.51 Typical High $79.43 | Facility | None | $1.23 | $2.51 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.07 Median $1.51 Typical High $12.59 | Professional | None | $1.07 | $1.51 | $12.59 |
Network Health Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Network Health Setting Professional Modifier None Typical Low $1.82 Median $2.34 Typical High $4.37 | Professional | None | $1.82 | $2.34 | $4.37 |
Prevea360 Setting Facility Modifier None Typical Low $0.68 Median $2.51 Typical High $2.88 | Facility | None | $0.68 | $2.51 | $2.88 |
Prevea360 Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $2.51 | Professional | None | $1.45 | $1.45 | $2.51 |
Quartz Setting Professional Modifier None Typical Low $2.57 Median $3.80 Typical High $5.13 | Professional | None | $2.57 | $3.80 | $5.13 |
Quartz Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.58 | Facility | None | $1.51 | $1.51 | $1.58 |
Quartz Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.62 | Professional | None | $1.29 | $1.29 | $1.62 |
Security Health Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Security Health Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.31 | Professional | None | $2.57 | $2.57 | $3.31 |
United Setting Professional Modifier None Typical Low $0.83 Median $1.26 Typical High $2.14 | Professional | None | $0.83 | $1.26 | $2.14 |
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 $0.27 Median $0.27 Typical High $0.76 | Professional | 55 · Aftercare only | $0.27 | $0.27 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.18 | Professional | RR · Rental | $0.13 | $0.13 | $0.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.93 Median $0.93 Typical High $1.35 | Professional | UE · Used equipment | $0.93 | $0.93 | $1.35 |
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
$2.40
ID $2.69CT $1.29
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.