How much rates vary
Facilitymedian $5 · 10th to 90th $3 to $10Professionalmedian $4 · 10th to 90th $3 to $6
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 $3.31 Median $3.31 Typical High $7.41 | Facility | None | $3.31 | $3.31 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $15.85 | Professional | None | $3.31 | $3.31 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $6.92 | Facility | None | $4.07 | $4.07 | $6.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $4.79 | Professional | None | $3.24 | $3.55 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $7.94 Typical High $9.77 | Facility | None | $4.79 | $7.94 | $9.77 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $4.17 Typical High $6.03 | Professional | None | $3.24 | $4.17 | $6.03 |
DeanCare Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $7.08 | Facility | None | $3.24 | $3.24 | $7.08 |
DeanCare Setting Professional Modifier None Typical Low $4.79 Median $6.46 Typical High $6.46 | Professional | None | $4.79 | $6.46 | $6.46 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $7.08 | Facility | None | $3.24 | $3.24 | $7.08 |
Medica Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.90 | Professional | None | $3.24 | $3.24 | $4.90 |
Network Health Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Prevea360 Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $7.08 | Facility | None | $3.24 | $3.24 | $7.08 |
Prevea360 Setting Professional Modifier None Typical Low $4.79 Median $6.46 Typical High $6.46 | Professional | None | $4.79 | $6.46 | $6.46 |
Quartz Setting Professional Modifier None Typical Low $3.24 Median $5.13 Typical High $8.51 | Professional | None | $3.24 | $5.13 | $8.51 |
Quartz Setting Facility Modifier None Typical Low $4.27 Median $9.77 Typical High $9.77 | Facility | None | $4.27 | $9.77 | $9.77 |
Quartz Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Security Health Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $5.37 | Professional | None | $4.37 | $4.37 | $5.37 |
United Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.47 | Professional | None | $3.24 | $3.24 | $4.47 |
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 $1.66 Median $1.66 Typical High $7.94 | Professional | 52 · Reduced service | $1.66 | $1.66 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $3.24 | Professional | 53 · Discontinued | $0.68 | $0.68 | $3.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.51 Median $2.51 Typical High $12.02 | Professional | 54 · Surgery only | $2.51 | $2.51 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.50 Typical High $2.40 | Professional | 55 · Aftercare only | $0.50 | $0.50 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $1.58 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $1.58 |
Where Wisconsin sits
The same service costs 1.7 times more in Arizona than in North Dakota. 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· 11th of 51
$3.72
AZ $5.50ND $3.24
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.