How much rates vary
Facilitymedian $5 · 10th to 90th $3 to $13Professionalmedian $5 · 10th to 90th $3 to $8
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 $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $15.85 | Professional | None | $3.63 | $3.63 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $5.62 Typical High $8.51 | Facility | None | $5.13 | $5.62 | $8.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $5.13 Typical High $6.31 | Professional | None | $3.24 | $5.13 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $13.49 Typical High $20.89 | Facility | None | $3.02 | $13.49 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $3.72 Typical High $9.55 | Professional | None | $2.57 | $3.72 | $9.55 |
DeanCare Setting Facility Modifier None Typical Low $1.38 Median $5.01 Typical High $5.75 | Facility | None | $1.38 | $5.01 | $5.75 |
DeanCare Setting Professional Modifier None Typical Low $5.50 Median $20.42 Typical High $21.38 | Professional | None | $5.50 | $20.42 | $21.38 |
Medica Setting Facility Modifier None Typical Low $2.45 Median $5.01 Typical High $79.43 | Facility | None | $2.45 | $5.01 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.29 Median $3.24 Typical High $25.12 | Professional | None | $2.29 | $3.24 | $25.12 |
Network Health Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Network Health Setting Professional Modifier None Typical Low $3.63 Median $4.68 Typical High $8.71 | Professional | None | $3.63 | $4.68 | $8.71 |
Prevea360 Setting Facility Modifier None Typical Low $1.38 Median $5.01 Typical High $5.75 | Facility | None | $1.38 | $5.01 | $5.75 |
Prevea360 Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $5.01 | Professional | None | $2.88 | $2.88 | $5.01 |
Quartz Setting Professional Modifier None Typical Low $4.79 Median $7.59 Typical High $10.96 | Professional | None | $4.79 | $7.59 | $10.96 |
Quartz Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.72 | Facility | None | $3.02 | $3.02 | $3.72 |
Quartz Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.72 | Professional | None | $2.57 | $2.57 | $3.72 |
Security Health Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Security Health Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $6.61 | Professional | None | $5.13 | $5.13 | $6.61 |
United Setting Professional Modifier None Typical Low $1.66 Median $2.51 Typical High $4.68 | Professional | None | $1.66 | $2.51 | $4.68 |
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 55 · Aftercare only Typical Low $0.54 Median $0.54 Typical High $2.40 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $1.58 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $1.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.33 Median $0.33 Typical High $0.36 | Professional | RR · Rental | $0.33 | $0.33 | $0.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.45 Median $2.69 Typical High $3.24 | Professional | UE · Used equipment | $2.45 | $2.69 | $3.24 |
Where Wisconsin sits
The same service costs 2.2 times more in Kansas than in Delaware. 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
$4.79
KS $5.75DE $2.57
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.