How much rates vary
Facilitymedian $5 · 10th to 90th $3 to $13Professionalmedian $4 · 10th to 90th $2 to $7
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 $3.31 Median $3.31 Typical High $3.31 | Facility | None | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $7.94 | Professional | None | $3.31 | $3.31 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.68 Median $5.25 Typical High $7.76 | Facility | None | $4.68 | $5.25 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.45 Median $4.68 Typical High $5.89 | Professional | None | $2.45 | $4.68 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $12.59 Typical High $19.50 | Facility | None | $2.57 | $12.59 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $7.94 | Professional | None | $1.91 | $2.19 | $7.94 |
DeanCare Setting Facility Modifier None Typical Low $1.26 Median $4.68 Typical High $5.37 | Facility | None | $1.26 | $4.68 | $5.37 |
DeanCare Setting Professional Modifier None Typical Low $3.89 Median $4.17 Typical High $5.01 | Professional | None | $3.89 | $4.17 | $5.01 |
Medica Setting Facility Modifier None Typical Low $2.24 Median $4.68 Typical High $79.43 | Facility | None | $2.24 | $4.68 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.95 Median $2.75 Typical High $22.39 | Professional | None | $1.95 | $2.75 | $22.39 |
Network Health Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Facility | None | $7.41 | $7.41 | $7.41 |
Network Health Setting Professional Modifier None Typical Low $3.31 Median $4.37 Typical High $8.13 | Professional | None | $3.31 | $4.37 | $8.13 |
Prevea360 Setting Facility Modifier None Typical Low $1.26 Median $4.68 Typical High $5.37 | Facility | None | $1.26 | $4.68 | $5.37 |
Prevea360 Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $4.68 | Professional | None | $2.63 | $2.63 | $4.68 |
Quartz Setting Professional Modifier None Typical Low $4.47 Median $6.46 Typical High $10.23 | Professional | None | $4.47 | $6.46 | $10.23 |
Quartz Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.82 | Facility | None | $2.57 | $2.57 | $2.82 |
Quartz Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.57 | Professional | None | $1.91 | $2.19 | $2.57 |
Security Health Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Security Health Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.17 | Professional | None | $4.68 | $4.68 | $6.17 |
United Setting Professional Modifier None Typical Low $1.55 Median $2.29 Typical High $3.98 | Professional | None | $1.55 | $2.29 | $3.98 |
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 $0.50 Median $0.50 Typical High $1.20 | Professional | 55 · Aftercare only | $0.50 | $0.50 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $0.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.23 Median $0.23 Typical High $0.30 | Professional | RR · Rental | $0.23 | $0.23 | $0.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.74 Median $2.29 Typical High $2.45 | Professional | UE · Used equipment | $1.74 | $2.29 | $2.45 |
Where Wisconsin sits
The same service costs 2.5 times more in Hawaii than in Vermont. 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· 5th of 51
$4.37
HI $5.50VT $2.19
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.