How much rates vary
Facilitymedian $18 · 10th to 90th $12 to $35Professionalmedian $13 · 10th to 90th $11 to $26
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 $11.75 Median $11.75 Typical High $26.92 | Facility | None | $11.75 | $11.75 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $44.67 | Professional | None | $11.75 | $11.75 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $25.12 | Facility | None | $14.13 | $14.13 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $12.59 Typical High $16.98 | Professional | None | $11.48 | $12.59 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $17.78 Median $30.90 Typical High $34.67 | Facility | None | $17.78 | $30.90 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $14.79 Typical High $22.91 | Professional | None | $11.48 | $14.79 | $22.91 |
DeanCare Setting Facility Modifier None Typical Low $11.22 Median $12.88 Typical High $28.18 | Facility | None | $11.22 | $12.88 | $28.18 |
DeanCare Setting Professional Modifier None Typical Low $19.50 Median $25.70 Typical High $25.70 | Professional | None | $19.50 | $25.70 | $25.70 |
Medica Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $29.51 | Facility | None | $13.18 | $13.18 | $29.51 |
Medica Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $19.95 | Professional | None | $13.18 | $13.18 | $19.95 |
Network Health Setting Facility Modifier None Typical Low $12.88 Median $13.49 Typical High $13.49 | Facility | None | $12.88 | $13.49 | $13.49 |
Prevea360 Setting Facility Modifier None Typical Low $11.22 Median $12.88 Typical High $28.18 | Facility | None | $11.22 | $12.88 | $28.18 |
Prevea360 Setting Professional Modifier None Typical Low $19.50 Median $25.70 Typical High $25.70 | Professional | None | $19.50 | $25.70 | $25.70 |
Quartz Setting Professional Modifier None Typical Low $11.22 Median $18.62 Typical High $33.11 | Professional | None | $11.22 | $18.62 | $33.11 |
Quartz Setting Facility Modifier None Typical Low $15.14 Median $34.67 Typical High $34.67 | Facility | None | $15.14 | $34.67 | $34.67 |
Quartz Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Security Health Setting Professional Modifier None Typical Low $12.88 Median $15.49 Typical High $19.05 | Professional | None | $12.88 | $15.49 | $19.05 |
United Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $15.85 | Professional | None | $11.75 | $11.75 | $15.85 |
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 $5.89 Median $5.89 Typical High $22.39 | Professional | 52 · Reduced service | $5.89 | $5.89 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $8.91 | Professional | 53 · Discontinued | $2.34 | $2.34 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.78 Typical High $6.76 | Professional | 55 · Aftercare only | $1.78 | $1.78 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $4.47 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $4.47 |
Where Wisconsin sits
The same service costs 1.8 times more in Alaska than in Georgia. 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
$13.49
AK $20.89GA $11.48
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.