How much rates vary
Facilitymedian $5 · 10th to 90th $3 to $13Professionalmedian $5 · 10th to 90th $2 to $8
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 $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $12.02 | Professional | None | $3.55 | $3.55 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.01 Median $5.50 Typical High $8.32 | Facility | None | $5.01 | $5.50 | $8.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $5.01 Typical High $6.31 | Professional | None | $2.51 | $5.01 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $13.49 Typical High $20.89 | Facility | None | $2.95 | $13.49 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $2.51 Median $3.47 Typical High $9.55 | Professional | None | $2.51 | $3.47 | $9.55 |
DeanCare Setting Facility Modifier None Typical Low $1.35 Median $4.90 Typical High $5.62 | Facility | None | $1.35 | $4.90 | $5.62 |
DeanCare Setting Professional Modifier None Typical Low $5.50 Median $9.55 Typical High $10.00 | Professional | None | $5.50 | $9.55 | $10.00 |
Medica Setting Facility Modifier None Typical Low $2.40 Median $4.90 Typical High $79.43 | Facility | None | $2.40 | $4.90 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.09 Median $2.95 Typical High $24.55 | Professional | None | $2.09 | $2.95 | $24.55 |
Network Health Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Network Health Setting Professional Modifier None Typical Low $3.55 Median $4.68 Typical High $8.71 | Professional | None | $3.55 | $4.68 | $8.71 |
Prevea360 Setting Facility Modifier None Typical Low $1.35 Median $4.90 Typical High $5.62 | Facility | None | $1.35 | $4.90 | $5.62 |
Prevea360 Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $4.90 | Professional | None | $2.82 | $2.82 | $4.90 |
Quartz Setting Professional Modifier None Typical Low $4.79 Median $7.08 Typical High $10.96 | Professional | None | $4.79 | $7.08 | $10.96 |
Quartz Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $3.16 | Facility | None | $2.95 | $2.95 | $3.16 |
Quartz Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $3.16 | Professional | None | $2.51 | $2.51 | $3.16 |
Security Health Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
Security Health Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $6.61 | Professional | None | $5.01 | $5.01 | $6.61 |
United Setting Professional Modifier None Typical Low $1.62 Median $2.45 Typical High $4.27 | Professional | None | $1.62 | $2.45 | $4.27 |
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 $0.52 Median $0.52 Typical High $1.82 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $1.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.24 Median $0.24 Typical High $0.35 | Professional | RR · Rental | $0.24 | $0.24 | $0.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.78 Median $1.78 Typical High $1.95 | Professional | UE · Used equipment | $1.78 | $1.78 | $1.95 |
Where Wisconsin sits
The same service costs 2.1 times more in Montana than in Colorado. 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
$4.68
MT $5.25CO $2.51
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.