How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $2Professionalmedian $1 · 10th to 90th $0 to $1
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 $0.39 Median $0.39 Typical High $0.39 | Facility | None | $0.39 | $0.39 | $0.39 |
Aetna Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $1.00 | Professional | None | $0.39 | $0.39 | $1.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.55 Median $0.62 Typical High $0.91 | Facility | None | $0.55 | $0.62 | $0.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.51 Median $0.51 Typical High $0.62 | Professional | None | $0.51 | $0.51 | $0.62 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $2.04 Typical High $3.09 | Facility | None | $1.82 | $2.04 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.56 Typical High $0.93 | Professional | None | $0.28 | $0.56 | $0.93 |
DeanCare Setting Facility Modifier None Typical Low $0.32 Median $0.54 Typical High $0.56 | Facility | None | $0.32 | $0.54 | $0.56 |
DeanCare Setting Professional Modifier None Typical Low $0.52 Median $0.95 Typical High $1.17 | Professional | None | $0.52 | $0.95 | $1.17 |
Medica Setting Facility Modifier None Typical Low $0.32 Median $0.54 Typical High $1.10 | Facility | None | $0.32 | $0.54 | $1.10 |
Medica Setting Professional Modifier None Typical Low $0.26 Median $0.37 Typical High $2.69 | Professional | None | $0.26 | $0.37 | $2.69 |
Network Health Setting Facility Modifier None Typical Low $0.91 Median $0.91 Typical High $0.91 | Facility | None | $0.91 | $0.91 | $0.91 |
Network Health Setting Professional Modifier None Typical Low $0.49 Median $0.52 Typical High $0.91 | Professional | None | $0.49 | $0.52 | $0.91 |
Prevea360 Setting Facility Modifier None Typical Low $0.32 Median $0.54 Typical High $0.56 | Facility | None | $0.32 | $0.54 | $0.56 |
Prevea360 Setting Professional Modifier None Typical Low $0.33 Median $0.54 Typical High $0.54 | Professional | None | $0.33 | $0.54 | $0.54 |
Quartz Setting Professional Modifier None Typical Low $0.42 Median $0.71 Typical High $0.87 | Professional | None | $0.42 | $0.71 | $0.87 |
Quartz Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Security Health Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Security Health Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.72 | Professional | None | $0.55 | $0.55 | $0.72 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.28 Typical High $0.52 | Professional | None | $0.18 | $0.28 | $0.52 |
5 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 $0.20 Median $0.20 Typical High $0.50 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.20 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.15 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.19 Median $0.25 Typical High $0.62 | Professional | UE · Used equipment | $0.19 | $0.25 | $0.62 |
Where Wisconsin sits
The same service costs 2.6 times more in Hawaii than in Utah. 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
$0.51
HI $0.59UT $0.23
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.