How much rates vary
Facilitymedian $14 · 10th to 90th $8 to $37Professionalmedian $13 · 10th to 90th $7 to $20
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 $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $20.89 | Professional | None | $9.55 | $9.55 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $15.14 Typical High $22.39 | Facility | None | $13.80 | $15.14 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.92 Median $13.80 Typical High $16.98 | Professional | None | $6.92 | $13.80 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $37.15 Typical High $56.23 | Facility | None | $8.13 | $37.15 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $9.55 Typical High $25.70 | Professional | None | $6.92 | $9.55 | $25.70 |
DeanCare Setting Facility Modifier None Typical Low $7.76 Median $13.49 Typical High $15.49 | Facility | None | $7.76 | $13.49 | $15.49 |
DeanCare Setting Professional Modifier None Typical Low $12.30 Median $13.49 Typical High $16.22 | Professional | None | $12.30 | $13.49 | $16.22 |
Medica Setting Facility Modifier None Typical Low $8.32 Median $13.49 Typical High $79.43 | Facility | None | $8.32 | $13.49 | $79.43 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $8.32 Typical High $66.07 | Professional | None | $5.75 | $8.32 | $66.07 |
Network Health Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Network Health Setting Professional Modifier None Typical Low $9.77 Median $12.59 Typical High $23.44 | Professional | None | $9.77 | $12.59 | $23.44 |
Prevea360 Setting Facility Modifier None Typical Low $7.76 Median $13.49 Typical High $15.49 | Facility | None | $7.76 | $13.49 | $15.49 |
Prevea360 Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Quartz Setting Professional Modifier None Typical Low $12.59 Median $18.20 Typical High $28.84 | Professional | None | $12.59 | $18.20 | $28.84 |
Quartz Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Facility | None | $8.13 | $8.13 | $8.51 |
Quartz Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.71 | Professional | None | $6.92 | $6.92 | $8.71 |
Security Health Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Security Health Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $17.78 | Professional | None | $13.80 | $13.80 | $17.78 |
United Setting Professional Modifier None Typical Low $4.47 Median $6.76 Typical High $11.48 | Professional | None | $4.47 | $6.76 | $11.48 |
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 $4.79 Median $4.79 Typical High $10.47 | Professional | 52 · Reduced service | $4.79 | $4.79 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $1.95 Typical High $4.17 | Professional | 53 · Discontinued | $1.95 | $1.95 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $3.16 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $0.98 Typical High $2.09 | Professional | 56 · Pre-op care only | $0.98 | $0.98 | $2.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.66 Median $0.66 Typical High $0.95 | Professional | RR · Rental | $0.66 | $0.66 | $0.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.90 Median $4.90 Typical High $5.37 | Professional | UE · Used equipment | $4.90 | $4.90 | $5.37 |
Where Wisconsin sits
The same service costs 2.2 times more in Hawaii than in Maine. 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
$12.59
HI $15.49ME $6.92
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.