How much rates vary
Facilitymedian $17 · 10th to 90th $10 to $44Professionalmedian $16 · 10th to 90th $8 to $26
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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $36.31 | Professional | None | $12.02 | $12.02 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $18.62 Typical High $28.18 | Facility | None | $16.98 | $18.62 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.59 Median $16.98 Typical High $21.38 | Professional | None | $7.59 | $16.98 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $43.65 Typical High $67.61 | Facility | None | $10.00 | $43.65 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $11.48 Typical High $32.36 | Professional | None | $8.51 | $11.48 | $32.36 |
DeanCare Setting Facility Modifier None Typical Low $4.57 Median $16.60 Typical High $19.05 | Facility | None | $4.57 | $16.60 | $19.05 |
DeanCare Setting Professional Modifier None Typical Low $16.60 Median $32.36 Typical High $33.88 | Professional | None | $16.60 | $32.36 | $33.88 |
Medica Setting Facility Modifier None Typical Low $8.13 Median $16.60 Typical High $79.43 | Facility | None | $8.13 | $16.60 | $79.43 |
Medica Setting Professional Modifier None Typical Low $7.08 Median $10.00 Typical High $83.18 | Professional | None | $7.08 | $10.00 | $83.18 |
Network Health Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Network Health Setting Professional Modifier None Typical Low $12.02 Median $15.49 Typical High $28.84 | Professional | None | $12.02 | $15.49 | $28.84 |
Prevea360 Setting Facility Modifier None Typical Low $4.57 Median $16.60 Typical High $19.05 | Facility | None | $4.57 | $16.60 | $19.05 |
Prevea360 Setting Professional Modifier None Typical Low $9.55 Median $14.13 Typical High $16.60 | Professional | None | $9.55 | $14.13 | $16.60 |
Quartz Setting Professional Modifier None Typical Low $15.49 Median $22.39 Typical High $35.48 | Professional | None | $15.49 | $22.39 | $35.48 |
Quartz Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.72 | Facility | None | $10.00 | $10.00 | $10.72 |
Quartz Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.72 | Professional | None | $8.51 | $8.51 | $10.72 |
Security Health Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Security Health Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $21.88 | Professional | None | $16.98 | $16.98 | $21.88 |
United Setting Professional Modifier None Typical Low $5.50 Median $8.32 Typical High $14.13 | Professional | None | $5.50 | $8.32 | $14.13 |
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 $1.82 Median $1.82 Typical High $5.37 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $3.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.71 Median $0.71 Typical High $1.12 | Professional | RR · Rental | $0.71 | $0.71 | $1.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.37 Median $5.75 Typical High $7.59 | Professional | UE · Used equipment | $5.37 | $5.75 | $7.59 |
Where Wisconsin sits
The same service costs 2.3 times more in Montana than in Connecticut. 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
$15.85
MT $17.38CT $7.59
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.