How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 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 $0.21 Median $0.21 Typical High $0.47 | Facility | None | $0.21 | $0.21 | $0.47 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.21 Typical High $3.98 | Professional | None | $0.20 | $0.21 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.25 Median $0.25 Typical High $0.25 | Facility | None | $0.25 | $0.25 | $0.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.20 Median $0.23 Typical High $0.58 | Professional | None | $0.20 | $0.23 | $0.58 |
CareSource Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
Cigna Setting Facility Modifier None Typical Low $0.31 Median $0.54 Typical High $0.62 | Facility | None | $0.31 | $0.54 | $0.62 |
Cigna Setting Professional Modifier None Typical Low $0.20 Median $0.26 Typical High $0.36 | Professional | None | $0.20 | $0.26 | $0.36 |
DeanCare Setting Facility Modifier None Typical Low $0.20 Median $0.20 Typical High $0.71 | Facility | None | $0.20 | $0.20 | $0.71 |
DeanCare Setting Professional Modifier None Typical Low $0.30 Median $0.40 Typical High $0.54 | Professional | None | $0.30 | $0.40 | $0.54 |
Medica Setting Facility Modifier None Typical Low $0.20 Median $1.48 Typical High $5.89 | Facility | None | $0.20 | $1.48 | $5.89 |
Medica Setting Professional Modifier None Typical Low $0.08 Median $0.20 Typical High $0.40 | Professional | None | $0.08 | $0.20 | $0.40 |
Network Health Setting Facility Modifier None Typical Low $0.18 Median $0.18 Typical High $0.18 | Facility | None | $0.18 | $0.18 | $0.18 |
Network Health Setting Professional Modifier None Typical Low $0.18 Median $0.20 Typical High $0.23 | Professional | None | $0.18 | $0.20 | $0.23 |
Prevea360 Setting Facility Modifier None Typical Low $0.20 Median $0.20 Typical High $0.71 | Facility | None | $0.20 | $0.20 | $0.71 |
Prevea360 Setting Professional Modifier None Typical Low $0.30 Median $0.40 Typical High $0.54 | Professional | None | $0.30 | $0.40 | $0.54 |
Quartz Setting Professional Modifier None Typical Low $0.20 Median $0.37 Typical High $0.91 | Professional | None | $0.20 | $0.37 | $0.91 |
Quartz Setting Facility Modifier None Typical Low $0.27 Median $0.62 Typical High $0.62 | Facility | None | $0.27 | $0.62 | $0.62 |
Quartz Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
Security Health Setting Professional Modifier None Typical Low $0.14 Median $0.27 Typical High $0.33 | Professional | None | $0.14 | $0.27 | $0.33 |
United Setting Professional Modifier None Typical Low $0.08 Median $0.21 Typical High $0.28 | Professional | None | $0.08 | $0.21 | $0.28 |
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 $0.11 Median $0.11 Typical High $3.02 | Professional | 52 · Reduced service | $0.11 | $0.11 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $1.20 | Professional | 53 · Discontinued | $0.04 | $0.04 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.89 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.60 |
Where Wisconsin sits
The same service costs 2.3 times more in Oklahoma than in Florida. 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· 7th of 51
$0.22
OK $0.47FL $0.20
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.