How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $11Professionalmedian $4 · 10th to 90th $2 to $6
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 $2.69 Median $2.69 Typical High $2.69 | Facility | None | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $6.03 | Professional | None | $2.69 | $2.69 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.89 Median $4.27 Typical High $6.31 | Facility | None | $3.89 | $4.27 | $6.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.00 Median $3.89 Typical High $4.79 | Professional | None | $2.00 | $3.89 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $10.72 Typical High $16.60 | Facility | None | $2.29 | $10.72 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $1.95 Median $2.69 Typical High $7.24 | Professional | None | $1.95 | $2.69 | $7.24 |
DeanCare Setting Facility Modifier None Typical Low $1.05 Median $3.80 Typical High $4.37 | Facility | None | $1.05 | $3.80 | $4.37 |
DeanCare Setting Professional Modifier None Typical Low $4.57 Median $6.46 Typical High $6.76 | Professional | None | $4.57 | $6.46 | $6.76 |
Medica Setting Facility Modifier None Typical Low $1.82 Median $3.80 Typical High $79.43 | Facility | None | $1.82 | $3.80 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.58 Median $2.29 Typical High $18.62 | Professional | None | $1.58 | $2.29 | $18.62 |
Network Health Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Network Health Setting Professional Modifier None Typical Low $2.75 Median $3.55 Typical High $6.61 | Professional | None | $2.75 | $3.55 | $6.61 |
Prevea360 Setting Facility Modifier None Typical Low $1.05 Median $3.80 Typical High $4.37 | Facility | None | $1.05 | $3.80 | $4.37 |
Prevea360 Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.80 | Professional | None | $2.14 | $2.14 | $3.80 |
Quartz Setting Professional Modifier None Typical Low $3.72 Median $5.37 Typical High $8.51 | Professional | None | $3.72 | $5.37 | $8.51 |
Quartz Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.40 | Facility | None | $2.29 | $2.29 | $2.40 |
Quartz Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.45 | Professional | None | $1.95 | $1.95 | $2.45 |
Security Health Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Security Health Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $5.01 | Professional | None | $3.89 | $3.89 | $5.01 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.86 Typical High $3.24 | Professional | None | $1.26 | $1.86 | $3.24 |
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 $0.41 Median $0.41 Typical High $0.89 | Professional | 55 · Aftercare only | $0.41 | $0.41 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.19 Median $0.19 Typical High $0.27 | Professional | RR · Rental | $0.19 | $0.19 | $0.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.41 Median $1.41 Typical High $2.04 | Professional | UE · Used equipment | $1.41 | $1.41 | $2.04 |
Where Wisconsin sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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
$3.63
ID $4.07NJ $1.95
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.