How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $6Professionalmedian $2 · 10th to 90th $2 to $4
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 $2.14 Median $2.14 Typical High $4.47 | Facility | None | $2.14 | $2.14 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $15.85 | Professional | None | $2.14 | $2.14 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $4.17 | Facility | None | $2.57 | $2.57 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.09 Median $2.29 Typical High $3.09 | Professional | None | $2.09 | $2.29 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $4.79 Typical High $6.31 | Facility | None | $2.88 | $4.79 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $2.09 Median $2.63 Typical High $3.63 | Professional | None | $2.09 | $2.63 | $3.63 |
DeanCare Setting Facility Modifier None Typical Low $1.32 Median $1.95 Typical High $4.27 | Facility | None | $1.32 | $1.95 | $4.27 |
DeanCare Setting Professional Modifier None Typical Low $2.95 Median $3.89 Typical High $3.89 | Professional | None | $2.95 | $3.89 | $3.89 |
Medica Setting Facility Modifier None Typical Low $1.32 Median $1.91 Typical High $4.27 | Facility | None | $1.32 | $1.91 | $4.27 |
Medica Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $2.88 | Professional | None | $1.91 | $1.91 | $2.88 |
Network Health Setting Facility Modifier None Typical Low $1.82 Median $1.91 Typical High $1.91 | Facility | None | $1.82 | $1.91 | $1.91 |
Prevea360 Setting Facility Modifier None Typical Low $1.32 Median $1.95 Typical High $4.27 | Facility | None | $1.32 | $1.95 | $4.27 |
Prevea360 Setting Professional Modifier None Typical Low $2.95 Median $3.89 Typical High $3.89 | Professional | None | $2.95 | $3.89 | $3.89 |
Quartz Setting Professional Modifier None Typical Low $2.09 Median $3.16 Typical High $5.13 | Professional | None | $2.09 | $3.16 | $5.13 |
Quartz Setting Facility Modifier None Typical Low $2.75 Median $6.31 Typical High $6.31 | Facility | None | $2.75 | $6.31 | $6.31 |
Quartz Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Security Health Setting Professional Modifier None Typical Low $1.51 Median $2.82 Typical High $3.47 | Professional | None | $1.51 | $2.82 | $3.47 |
United Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
United Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.69 | Professional | None | $1.95 | $1.95 | $2.69 |
5 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 $1.07 Median $1.07 Typical High $7.94 | Professional | 52 · Reduced service | $1.07 | $1.07 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $3.24 | Professional | 53 · Discontinued | $0.43 | $0.43 | $3.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.62 Median $1.62 Typical High $12.02 | Professional | 54 · Surgery only | $1.62 | $1.62 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $2.40 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $1.58 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $1.58 |
Where Wisconsin sits
The same service costs 1.6 times more in Alaska than in Iowa. 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· 5th of 51
$2.40
AK $3.09IA $1.95
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.