How much rates vary
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 $0.36 Median $0.36 Typical High $0.36 | Facility | None | $0.36 | $0.36 | $0.36 |
Aetna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $3.98 | Professional | None | $0.36 | $0.36 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.40 Median $0.44 Typical High $0.66 | Facility | None | $0.40 | $0.44 | $0.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.50 | Professional | None | $0.37 | $0.37 | $0.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | UE · Used equipment | $0.37 | $0.37 | $0.37 |
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 $0.24 Median $0.47 Typical High $0.72 | Professional | None | $0.24 | $0.47 | $0.72 |
DeanCare Setting Facility Modifier None Typical Low $0.31 Median $0.38 Typical High $0.58 | Facility | None | $0.31 | $0.38 | $0.58 |
DeanCare Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Medica Setting Facility Modifier None Typical Low $0.31 Median $0.39 Typical High $89.13 | Facility | None | $0.31 | $0.39 | $89.13 |
Medica Setting Professional Modifier None Typical Low $0.23 Median $0.76 Typical High $2.09 | Professional | None | $0.23 | $0.76 | $2.09 |
Network Health Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | None | $0.91 | $0.91 | $0.91 |
Prevea360 Setting Facility Modifier None Typical Low $0.31 Median $0.38 Typical High $0.58 | Facility | None | $0.31 | $0.38 | $0.58 |
Prevea360 Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Quartz Setting Professional Modifier None Typical Low $0.37 Median $0.54 Typical High $0.87 | Professional | None | $0.37 | $0.54 | $0.87 |
Quartz Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | None | $0.24 | $0.24 | $0.24 |
Security Health Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | None | $0.58 | $0.58 | $0.58 |
Security Health Setting Facility Modifier None Typical Low $0.59 Median $0.59 Typical High $0.59 | Facility | None | $0.59 | $0.59 | $0.59 |
Security Health Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.76 | Professional | None | $0.58 | $0.58 | $0.76 |
United Setting Professional Modifier None Typical Low $0.16 Median $0.72 Typical High $2.09 | Professional | None | $0.16 | $0.72 | $2.09 |
2 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 $0.05 Median $0.05 Typical High $0.60 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.40 |
Where Wisconsin sits
The same service costs 3.1 times more in Florida than in Alabama. 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· 29th of 51
$0.40
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.