How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $3Professionalmedian $1 · 10th to 90th $1 to $2
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 $0.79 Median $0.79 Typical High $0.79 | Facility | None | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $2.00 | Professional | None | $0.79 | $0.79 | $2.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.12 Median $1.23 Typical High $1.86 | Facility | None | $1.12 | $1.23 | $1.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.26 | Professional | None | $1.05 | $1.05 | $1.26 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $3.09 Typical High $4.57 | Facility | None | $2.69 | $3.09 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $1.12 Typical High $1.86 | Professional | None | $0.55 | $1.12 | $1.86 |
DeanCare Setting Facility Modifier None Typical Low $0.63 Median $1.10 Typical High $1.15 | Facility | None | $0.63 | $1.10 | $1.15 |
DeanCare Setting Professional Modifier None Typical Low $1.00 Median $2.04 Typical High $2.45 | Professional | None | $1.00 | $2.04 | $2.45 |
Medica Setting Facility Modifier None Typical Low $0.63 Median $1.10 Typical High $2.24 | Facility | None | $0.63 | $1.10 | $2.24 |
Medica Setting Professional Modifier None Typical Low $0.50 Median $0.72 Typical High $5.50 | Professional | None | $0.50 | $0.72 | $5.50 |
Network Health Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
Network Health Setting Professional Modifier None Typical Low $0.95 Median $1.02 Typical High $1.86 | Professional | None | $0.95 | $1.02 | $1.86 |
Prevea360 Setting Facility Modifier None Typical Low $0.63 Median $1.10 Typical High $1.15 | Facility | None | $0.63 | $1.10 | $1.15 |
Prevea360 Setting Professional Modifier None Typical Low $0.62 Median $1.10 Typical High $1.10 | Professional | None | $0.62 | $1.10 | $1.10 |
Quartz Setting Professional Modifier None Typical Low $1.12 Median $1.70 Typical High $2.51 | Professional | None | $1.12 | $1.70 | $2.51 |
Quartz 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 $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Security Health Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.45 | Professional | None | $1.12 | $1.12 | $1.45 |
The Alliance Setting Professional Modifier None Typical Low $0.71 Median $1.32 Typical High $6.92 | Professional | None | $0.71 | $1.32 | $6.92 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.55 Typical High $1.00 | Professional | None | $0.36 | $0.55 | $1.00 |
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 $0.40 Median $0.40 Typical High $1.00 | Professional | 52 · Reduced service | $0.40 | $0.40 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.40 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.30 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.36 Median $1.17 Typical High $1.17 | Professional | UE · Used equipment | $0.36 | $1.17 | $1.17 |
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· 10th of 51
$1.05
HI $1.17UT $0.46
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.