How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $1
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 $0.20 Median $0.20 Typical High $0.38 | Facility | None | $0.20 | $0.20 | $0.38 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.22 | Professional | None | $0.20 | $0.20 | $0.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.25 Median $0.25 Typical High $0.25 | Facility | None | $0.25 | $0.25 | $0.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.20 Median $0.30 Typical High $0.30 | Professional | None | $0.20 | $0.30 | $0.30 |
CareSource Setting Professional Modifier None Typical Low $0.19 Median $0.19 Typical High $0.28 | Professional | None | $0.19 | $0.19 | $0.28 |
Cigna Setting Facility Modifier None Typical Low $0.28 Median $0.36 Typical High $0.62 | Facility | None | $0.28 | $0.36 | $0.62 |
Cigna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.28 | Professional | None | $0.20 | $0.20 | $0.28 |
DeanCare Setting Facility Modifier None Typical Low $0.19 Median $0.19 Typical High $3.24 | Facility | None | $0.19 | $0.19 | $3.24 |
DeanCare Setting Professional Modifier None Typical Low $0.25 Median $0.25 Typical High $0.83 | Professional | None | $0.25 | $0.25 | $0.83 |
Medica Setting Facility Modifier None Typical Low $0.23 Median $0.33 Typical High $4.79 | Facility | None | $0.23 | $0.33 | $4.79 |
Medica Setting Professional Modifier None Typical Low $0.23 Median $0.25 Typical High $4.07 | Professional | None | $0.23 | $0.25 | $4.07 |
Network Health Setting Facility Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Facility | None | $0.40 | $0.40 | $0.40 |
Network Health Setting Professional Modifier None Typical Low $0.24 Median $0.27 Typical High $0.28 | Professional | None | $0.24 | $0.27 | $0.28 |
Prevea360 Setting Facility Modifier None Typical Low $0.19 Median $0.19 Typical High $3.24 | Facility | None | $0.19 | $0.19 | $3.24 |
Prevea360 Setting Professional Modifier None Typical Low $0.28 Median $0.38 Typical High $0.38 | Professional | None | $0.28 | $0.38 | $0.38 |
Quartz Setting Professional Modifier None Typical Low $0.20 Median $0.52 Typical High $0.85 | Professional | None | $0.20 | $0.52 | $0.85 |
Quartz Setting Facility Modifier None Typical Low $0.33 Median $0.62 Typical High $0.62 | Facility | None | $0.33 | $0.62 | $0.62 |
Quartz Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
Security Health Setting Professional Modifier None Typical Low $0.27 Median $0.33 Typical High $0.55 | Professional | None | $0.27 | $0.33 | $0.55 |
The Alliance Setting Professional Modifier None Typical Low $0.43 Median $0.83 Typical High $1.41 | Professional | None | $0.43 | $0.83 | $1.41 |
United Setting Professional Modifier None Typical Low $0.16 Median $0.18 Typical High $4.07 | Professional | None | $0.16 | $0.18 | $4.07 |
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 $0.10 Median $0.10 Typical High $7.08 | Professional | 52 · Reduced service | $0.10 | $0.10 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $4.37 | Professional | 53 · Discontinued | $0.04 | $0.04 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $3.31 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $2.19 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $2.19 |
Where Wisconsin sits
The same service costs 3.8 times more in Wyoming than in Michigan. 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· 9th of 51
$0.23
WY $0.76MI $0.20
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.