How much rates vary
Facilitymedian $9 · 10th to 90th $7 to $22Professionalmedian $8 · 10th to 90th $4 to $13
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 $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $5.89 Typical High $10.00 | Professional | None | $4.90 | $5.89 | $10.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.32 Median $9.33 Typical High $13.80 | Facility | None | $8.32 | $9.33 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $9.33 | Professional | None | $7.76 | $7.76 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $25.70 Typical High $38.02 | Facility | None | $22.39 | $25.70 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $8.51 Typical High $14.13 | Professional | None | $4.27 | $8.51 | $14.13 |
DeanCare Setting Facility Modifier None Typical Low $4.79 Median $8.32 Typical High $8.71 | Facility | None | $4.79 | $8.32 | $8.71 |
DeanCare Setting Professional Modifier None Typical Low $7.59 Median $10.23 Typical High $12.30 | Professional | None | $7.59 | $10.23 | $12.30 |
Medica Setting Facility Modifier None Typical Low $4.79 Median $8.32 Typical High $16.60 | Facility | None | $4.79 | $8.32 | $16.60 |
Medica Setting Professional Modifier None Typical Low $3.80 Median $5.50 Typical High $40.74 | Professional | None | $3.80 | $5.50 | $40.74 |
Network Health Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Network Health Setting Professional Modifier None Typical Low $7.24 Median $7.76 Typical High $14.13 | Professional | None | $7.24 | $7.76 | $14.13 |
Prevea360 Setting Facility Modifier None Typical Low $4.79 Median $8.32 Typical High $8.71 | Facility | None | $4.79 | $8.32 | $8.71 |
Prevea360 Setting Professional Modifier None Typical Low $4.68 Median $8.32 Typical High $8.32 | Professional | None | $4.68 | $8.32 | $8.32 |
Quartz Setting Professional Modifier None Typical Low $7.76 Median $12.59 Typical High $17.78 | Professional | None | $7.76 | $12.59 | $17.78 |
Quartz Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Security Health Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Security Health Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $10.96 | Professional | None | $8.32 | $8.32 | $10.96 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.07 Typical High $7.59 | Professional | None | $2.75 | $4.07 | $7.59 |
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 $2.95 Median $2.95 Typical High $5.01 | Professional | 52 · Reduced service | $2.95 | $2.95 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.20 Typical High $2.00 | Professional | 53 · Discontinued | $1.20 | $1.20 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.89 Typical High $1.51 | Professional | 55 · Aftercare only | $0.89 | $0.89 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.59 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.59 | $0.59 | $1.00 |
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· 8th of 51
$7.76
HI $9.12UT $3.47
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.