How much rates vary
Facilitymedian $2 · 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 $1.12 Median $1.12 Typical High $2.34 | Facility | None | $1.12 | $1.12 | $2.34 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.12 Typical High $1.12 | Professional | None | $1.10 | $1.12 | $1.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Facility | None | $1.35 | $1.35 | $1.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.38 | Professional | None | $1.10 | $1.10 | $1.38 |
CareSource Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $2.24 | Professional | None | $1.48 | $1.48 | $2.24 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $2.95 Typical High $3.39 | Facility | None | $1.70 | $2.95 | $3.39 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $2.09 | Professional | None | $1.10 | $1.10 | $2.09 |
DeanCare Setting Facility Modifier None Typical Low $1.48 Median $1.48 Typical High $3.55 | Facility | None | $1.48 | $1.48 | $3.55 |
DeanCare Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Medica Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $7.94 | Facility | None | $1.41 | $1.41 | $7.94 |
Medica Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.95 | Professional | None | $1.41 | $1.41 | $1.95 |
Network Health Setting Facility Modifier None Typical Low $1.51 Median $1.74 Typical High $1.74 | Facility | None | $1.51 | $1.74 | $1.74 |
Network Health Setting Professional Modifier None Typical Low $1.29 Median $1.45 Typical High $1.55 | Professional | None | $1.29 | $1.45 | $1.55 |
Prevea360 Setting Facility Modifier None Typical Low $1.48 Median $1.48 Typical High $3.55 | Facility | None | $1.48 | $1.48 | $3.55 |
Prevea360 Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Quartz Setting Professional Modifier None Typical Low $1.10 Median $2.09 Typical High $3.39 | Professional | None | $1.10 | $2.09 | $3.39 |
Quartz Setting Facility Modifier None Typical Low $1.45 Median $3.31 Typical High $3.31 | Facility | None | $1.45 | $3.31 | $3.31 |
Quartz Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Security Health Setting Professional Modifier None Typical Low $1.48 Median $1.82 Typical High $2.63 | Professional | None | $1.48 | $1.82 | $2.63 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.41 | Professional | None | $1.02 | $1.02 | $1.41 |
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 $0.55 Median $0.56 Typical High $0.56 | Professional | 52 · Reduced service | $0.55 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.16 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where Wisconsin sits
The same service costs 2.7 times more in Wyoming 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· 17th of 51
$1.12
WY $2.95AL $1.10
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.