How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $8Professionalmedian $3 · 10th to 90th $2 to $5
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 $2.63 Median $2.63 Typical High $5.62 | Facility | None | $2.63 | $2.63 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $5.01 | Professional | None | $2.63 | $2.63 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $5.25 | Facility | None | $3.24 | $3.24 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.57 Median $2.82 Typical High $3.89 | Professional | None | $2.57 | $2.82 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $6.03 Typical High $7.94 | Facility | None | $3.63 | $6.03 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $3.31 Typical High $4.57 | Professional | None | $2.57 | $3.31 | $4.57 |
DeanCare Setting Facility Modifier None Typical Low $2.00 Median $2.45 Typical High $5.75 | Facility | None | $2.00 | $2.45 | $5.75 |
DeanCare Setting Professional Modifier None Typical Low $3.63 Median $4.90 Typical High $4.90 | Professional | None | $3.63 | $4.90 | $4.90 |
Medica Setting Facility Modifier None Typical Low $2.00 Median $2.40 Typical High $5.01 | Facility | None | $2.00 | $2.40 | $5.01 |
Medica Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $3.63 | Professional | None | $2.40 | $2.40 | $3.63 |
Network Health Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
Prevea360 Setting Facility Modifier None Typical Low $2.00 Median $2.45 Typical High $5.75 | Facility | None | $2.00 | $2.45 | $5.75 |
Prevea360 Setting Professional Modifier None Typical Low $3.63 Median $4.90 Typical High $4.90 | Professional | None | $3.63 | $4.90 | $4.90 |
Quartz Setting Professional Modifier None Typical Low $2.57 Median $3.72 Typical High $5.89 | Professional | None | $2.57 | $3.72 | $5.89 |
Quartz Setting Facility Modifier None Typical Low $3.47 Median $7.94 Typical High $7.94 | Facility | None | $3.47 | $7.94 | $7.94 |
Quartz Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Security Health Setting Professional Modifier None Typical Low $2.14 Median $3.47 Typical High $4.27 | Professional | None | $2.14 | $3.47 | $4.27 |
United Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.39 | Professional | None | $2.45 | $2.45 | $3.39 |
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 $1.32 Median $1.32 Typical High $2.51 | Professional | 52 · Reduced service | $1.32 | $1.32 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $1.00 | Professional | 53 · Discontinued | $0.52 | $0.52 | $1.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.00 Median $2.00 Typical High $3.72 | Professional | 54 · Surgery only | $2.00 | $2.00 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.40 Typical High $0.76 | Professional | 55 · Aftercare only | $0.40 | $0.40 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.50 |
Where Wisconsin sits
The same service costs 1.8 times more in Alaska than in Maryland. 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· 8th of 51
$2.95
AK $4.47MD $2.45
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.