How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $7Professionalmedian $2 · 10th to 90th $1 to $4
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 $1.86 Median $1.86 Typical High $1.86 | Facility | None | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $3.02 | Professional | None | $1.86 | $1.86 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.63 Median $2.95 Typical High $4.37 | Facility | None | $2.63 | $2.95 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | None | $2.45 | $2.45 | $2.95 |
Cigna Setting Facility Modifier None Typical Low $7.24 Median $8.13 Typical High $12.30 | Facility | None | $7.24 | $8.13 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $2.69 Typical High $4.47 | Professional | None | $1.32 | $2.69 | $4.47 |
DeanCare Setting Facility Modifier None Typical Low $1.51 Median $2.63 Typical High $2.75 | Facility | None | $1.51 | $2.63 | $2.75 |
DeanCare Setting Professional Modifier None Typical Low $2.40 Median $3.02 Typical High $3.39 | Professional | None | $2.40 | $3.02 | $3.39 |
Medica Setting Facility Modifier None Typical Low $1.51 Median $2.63 Typical High $5.25 | Facility | None | $1.51 | $2.63 | $5.25 |
Medica Setting Professional Modifier None Typical Low $1.23 Median $1.74 Typical High $12.88 | Professional | None | $1.23 | $1.74 | $12.88 |
Network Health Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Network Health Setting Professional Modifier None Typical Low $2.29 Median $2.45 Typical High $4.47 | Professional | None | $2.29 | $2.45 | $4.47 |
Prevea360 Setting Facility Modifier None Typical Low $1.51 Median $2.63 Typical High $2.75 | Facility | None | $1.51 | $2.63 | $2.75 |
Prevea360 Setting Professional Modifier None Typical Low $1.51 Median $2.63 Typical High $2.63 | Professional | None | $1.51 | $2.63 | $2.63 |
Quartz Setting Professional Modifier None Typical Low $2.63 Median $3.98 Typical High $5.89 | Professional | None | $2.63 | $3.98 | $5.89 |
Quartz Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Security Health Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
Security Health Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $3.47 | Professional | None | $2.63 | $2.63 | $3.47 |
The Alliance Setting Professional Modifier None Typical Low $3.63 Median $5.37 Typical High $16.22 | Professional | None | $3.63 | $5.37 | $16.22 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.32 Typical High $2.45 | Professional | None | $0.87 | $1.32 | $2.45 |
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 52 · Reduced service Typical Low $0.93 Median $0.93 Typical High $1.51 | Professional | 52 · Reduced service | $0.93 | $0.93 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.38 Typical High $0.60 | Professional | 53 · Discontinued | $0.38 | $0.38 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.45 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.30 |
Where Wisconsin sits
The same service costs 2.6 times more in Hawaii 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· 11th of 51
$2.45
HI $2.88CO $1.12
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.