How much rates vary
Facilitymedian $7 · 10th to 90th $4 to $18Professionalmedian $6 · 10th to 90th $3 to $10
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 $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $18.20 | Professional | None | $4.79 | $4.79 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.76 Median $7.41 Typical High $10.96 | Facility | None | $6.76 | $7.41 | $10.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.82 Median $6.76 Typical High $8.71 | Professional | None | $2.82 | $6.76 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $18.20 Typical High $27.54 | Facility | None | $3.98 | $18.20 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $4.57 Typical High $12.59 | Professional | None | $3.39 | $4.57 | $12.59 |
DeanCare Setting Facility Modifier None Typical Low $1.82 Median $6.61 Typical High $7.59 | Facility | None | $1.82 | $6.61 | $7.59 |
DeanCare Setting Professional Modifier None Typical Low $6.61 Median $9.12 Typical High $9.55 | Professional | None | $6.61 | $9.12 | $9.55 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $6.61 Typical High $79.43 | Facility | None | $3.24 | $6.61 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.02 Median $4.17 Typical High $31.62 | Professional | None | $3.02 | $4.17 | $31.62 |
Network Health Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Network Health Setting Professional Modifier None Typical Low $4.79 Median $6.17 Typical High $11.48 | Professional | None | $4.79 | $6.17 | $11.48 |
Prevea360 Setting Facility Modifier None Typical Low $1.82 Median $6.61 Typical High $7.59 | Facility | None | $1.82 | $6.61 | $7.59 |
Prevea360 Setting Professional Modifier None Typical Low $3.80 Median $5.62 Typical High $6.61 | Professional | None | $3.80 | $5.62 | $6.61 |
Quartz Setting Professional Modifier None Typical Low $6.31 Median $9.12 Typical High $14.45 | Professional | None | $6.31 | $9.12 | $14.45 |
Quartz Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Quartz Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $4.27 | Professional | None | $3.39 | $3.39 | $4.27 |
Security Health Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Security Health Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $8.71 | Professional | None | $6.76 | $6.76 | $8.71 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.31 Typical High $6.17 | Professional | None | $2.19 | $3.31 | $6.17 |
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 $0.71 Median $0.71 Typical High $2.69 | Professional | 55 · Aftercare only | $0.71 | $0.71 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.47 Typical High $1.82 | Professional | 56 · Pre-op care only | $0.47 | $0.47 | $1.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.28 Median $0.28 Typical High $0.44 | Professional | RR · Rental | $0.28 | $0.28 | $0.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.09 Median $2.29 Typical High $2.82 | Professional | UE · Used equipment | $2.09 | $2.29 | $2.82 |
Where Wisconsin sits
The same service costs 2.2 times more in Minnesota 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· 2nd of 51
$6.31
MN $6.31CT $2.82
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.