How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $7.94 | Professional | None | $0.15 | $0.15 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $1.20 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.45 Median $1.70 Typical High $1.70 | Professional | None | $1.45 | $1.70 | $1.70 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $1.02 Typical High $1.51 | Facility | None | $0.89 | $1.02 | $1.51 |
Cigna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.48 | Professional | None | $0.02 | $0.02 | $0.48 |
DeanCare Setting Facility Modifier None Typical Low $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
DeanCare Setting Professional Modifier None Typical Low $19.05 Median $22.39 Typical High $27.54 | Professional | None | $19.05 | $22.39 | $27.54 |
Medica Setting Facility Modifier None Typical Low $0.15 Median $0.15 Typical High $100.00 | Facility | None | $0.15 | $0.15 | $100.00 |
Medica Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.39 | Professional | None | $0.20 | $0.20 | $0.39 |
Prevea360 Setting Facility Modifier None Typical Low $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
Quartz Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Quartz Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
United Setting Professional Modifier None Typical Low $0.14 Median $0.20 Typical High $0.39 | Professional | None | $0.14 | $0.20 | $0.39 |
1 more rate 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.14 Median $0.14 Typical High $0.17 | Professional | RR · Rental | $0.14 | $0.14 | $0.17 |
Where Wisconsin sits
The same service costs 24.5 times more in North Carolina than in Oregon. 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· 27th of 51
$0.20
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.