How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $5Professionalmedian $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 $1.45 Median $1.45 Typical High $1.45 | Facility | None | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $6.03 | Professional | None | $1.45 | $1.45 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.04 Median $2.24 Typical High $3.39 | Facility | None | $2.04 | $2.24 | $3.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.05 Median $2.04 Typical High $2.63 | Professional | None | $1.05 | $2.04 | $2.63 |
Cigna Setting Facility Modifier None Typical Low $1.20 Median $5.37 Typical High $8.32 | Facility | None | $1.20 | $5.37 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.38 Typical High $3.89 | Professional | None | $1.02 | $1.38 | $3.89 |
DeanCare Setting Facility Modifier None Typical Low $0.55 Median $2.00 Typical High $2.29 | Facility | None | $0.55 | $2.00 | $2.29 |
DeanCare Setting Professional Modifier None Typical Low $2.00 Median $4.47 Typical High $4.68 | Professional | None | $2.00 | $4.47 | $4.68 |
Medica Setting Facility Modifier None Typical Low $0.98 Median $2.00 Typical High $79.43 | Facility | None | $0.98 | $2.00 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.85 Median $1.20 Typical High $9.77 | Professional | None | $0.85 | $1.20 | $9.77 |
Network Health Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
Network Health Setting Professional Modifier None Typical Low $1.45 Median $1.91 Typical High $3.55 | Professional | None | $1.45 | $1.91 | $3.55 |
Prevea360 Setting Facility Modifier None Typical Low $0.55 Median $2.00 Typical High $2.29 | Facility | None | $0.55 | $2.00 | $2.29 |
Prevea360 Setting Professional Modifier None Typical Low $1.15 Median $1.86 Typical High $2.00 | Professional | None | $1.15 | $1.86 | $2.00 |
Quartz Setting Professional Modifier None Typical Low $2.04 Median $3.09 Typical High $4.27 | Professional | None | $2.04 | $3.09 | $4.27 |
Quartz Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1.29 | Facility | None | $1.20 | $1.20 | $1.29 |
Quartz Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.29 | Professional | None | $1.02 | $1.02 | $1.29 |
Security Health Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
Security Health Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.69 | Professional | None | $2.04 | $2.04 | $2.69 |
United Setting Professional Modifier None Typical Low $0.68 Median $1.00 Typical High $1.74 | Professional | None | $0.68 | $1.00 | $1.74 |
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 $0.22 Median $0.22 Typical High $0.89 | Professional | 55 · Aftercare only | $0.22 | $0.22 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.10 Median $0.10 Typical High $0.14 | Professional | RR · Rental | $0.10 | $0.10 | $0.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.74 Median $0.79 Typical High $1.05 | Professional | UE · Used equipment | $0.74 | $0.79 | $1.05 |
Where Wisconsin sits
The same service costs 2.1 times more in Kansas than in Kentucky. 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· 10th of 51
$1.91
KS $2.14KY $1.00
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.