How much rates vary
Facilitymedian $60 · 10th to 90th $41 to $174Professionalmedian $56 · 10th to 90th $33 to $126
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 $34.67 Median $50.12 Typical High $50.12 | Facility | None | $34.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $223.87 | Professional | None | $34.67 | $50.12 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $69.18 Typical High $100.00 | Facility | None | $60.26 | $69.18 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $70.79 | Professional | None | $56.23 | $56.23 | $70.79 |
CareSource Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $93.33 | Professional | None | $60.26 | $60.26 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $173.78 Typical High $263.03 | Facility | None | $40.74 | $173.78 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $100.00 | Professional | None | $34.67 | $34.67 | $100.00 |
DeanCare Setting Facility Modifier None Typical Low $34.67 Median $58.88 Typical High $70.79 | Facility | None | $34.67 | $58.88 | $70.79 |
DeanCare Setting Professional Modifier None Typical Low $53.70 Median $128.82 Typical High $147.91 | Professional | None | $53.70 | $128.82 | $147.91 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $64.57 Typical High $281.84 | Facility | None | $42.66 | $64.57 | $281.84 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $54.95 Typical High $316.23 | Professional | None | $31.62 | $54.95 | $316.23 |
Network Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Network Health Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $95.50 | Professional | None | $56.23 | $61.66 | $95.50 |
Prevea360 Setting Facility Modifier None Typical Low $34.67 Median $58.88 Typical High $70.79 | Facility | None | $34.67 | $58.88 | $70.79 |
Prevea360 Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Quartz Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $144.54 | Professional | None | $60.26 | $91.20 | $144.54 |
Quartz Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $50.12 | Facility | None | $40.74 | $40.74 | $50.12 |
Quartz Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | None | $34.67 | $34.67 | $40.74 |
United Setting Professional Modifier None Typical Low $21.38 Median $32.36 Typical High $83.18 | Professional | None | $21.38 | $32.36 | $83.18 |
6 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 $6.31 Median $7.59 Typical High $34.67 | Professional | 55 · Aftercare only | $6.31 | $7.59 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $22.91 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $22.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.89 Median $3.89 Typical High $4.27 | Professional | RR · Rental | $3.89 | $3.89 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | UE · Used equipment | $28.84 | $28.84 | $31.62 |
Cigna Setting Professional Modifier RR · Rental Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $100.00 | $100.00 | $100.00 |
Quartz Setting Professional Modifier RR · Rental Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $100.00 | $100.00 | $100.00 |
Where Wisconsin sits
The same service costs 6.6 times more in Hawaii than in Wyoming. 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· 12th of 51
$56.23
HI $79.43WY $12.02
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.