How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $2Professionalmedian $1 · 10th to 90th $1 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 $0.60 Median $0.60 Typical High $1.55 | Facility | None | $0.60 | $0.60 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $6.03 | Professional | None | $0.60 | $0.60 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.72 Median $0.72 Typical High $1.45 | Facility | None | $0.72 | $0.72 | $1.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.58 Median $0.63 Typical High $0.87 | Professional | None | $0.58 | $0.63 | $0.87 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $1.62 Typical High $1.82 | Facility | None | $0.89 | $1.62 | $1.82 |
Cigna Setting Professional Modifier None Typical Low $0.58 Median $0.78 Typical High $1.26 | Professional | None | $0.58 | $0.78 | $1.26 |
DeanCare Setting Facility Modifier None Typical Low $0.71 Median $0.71 Typical High $1.41 | Facility | None | $0.71 | $0.71 | $1.41 |
DeanCare Setting Professional Modifier None Typical Low $1.05 Median $1.41 Typical High $1.41 | Professional | None | $1.05 | $1.41 | $1.41 |
Medica Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $1.41 | Facility | None | $0.65 | $0.65 | $1.41 |
Medica Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $1.41 | Professional | None | $0.65 | $0.65 | $1.41 |
Network Health Setting Facility Modifier None Typical Low $0.52 Median $0.52 Typical High $0.95 | Facility | None | $0.52 | $0.52 | $0.95 |
Prevea360 Setting Facility Modifier None Typical Low $0.71 Median $0.71 Typical High $1.41 | Facility | None | $0.71 | $0.71 | $1.41 |
Prevea360 Setting Professional Modifier None Typical Low $1.05 Median $1.41 Typical High $1.41 | Professional | None | $1.05 | $1.41 | $1.41 |
Quartz Setting Professional Modifier None Typical Low $0.58 Median $1.10 Typical High $2.14 | Professional | None | $0.58 | $1.10 | $2.14 |
Quartz Setting Facility Modifier None Typical Low $0.78 Median $1.78 Typical High $1.78 | Facility | None | $0.78 | $1.78 | $1.78 |
Quartz Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | None | $0.58 | $0.58 | $0.58 |
Security Health Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $0.95 | Professional | None | $0.78 | $0.78 | $0.95 |
United Setting Facility Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Facility | None | $0.58 | $0.58 | $0.58 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.93 | Professional | None | $0.68 | $0.68 | $0.93 |
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 $0.30 Median $0.30 Typical High $3.02 | Professional | 52 · Reduced service | $0.30 | $0.30 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $1.20 | Professional | 53 · Discontinued | $0.12 | $0.12 | $1.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $0.45 Median $0.45 Typical High $4.47 | Professional | 54 · Surgery only | $0.45 | $0.45 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.89 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.60 |
Where Wisconsin sits
The same service costs 4.1 times more in Wyoming than in Delaware. 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· 16th of 51
$0.71
WY $2.34DE $0.58
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.