How much rates vary
Facilitymedian $19 · 10th to 90th $12 to $35Professionalmedian $13 · 10th to 90th $11 to $50
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 $12.02 Median $12.02 Typical High $32.36 | Facility | None | $12.02 | $12.02 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $77.62 | Professional | None | $12.02 | $12.02 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $30.20 | Facility | None | $14.45 | $14.45 | $30.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $17.38 | Professional | None | $11.48 | $11.48 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $33.11 Typical High $38.02 | Facility | None | $18.20 | $33.11 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $24.55 | Professional | None | $11.48 | $11.48 | $24.55 |
DeanCare Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $26.92 | Facility | None | $12.30 | $12.30 | $26.92 |
DeanCare Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $24.55 | Professional | None | $19.05 | $19.05 | $24.55 |
Medica Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $26.30 | Facility | None | $12.02 | $12.02 | $26.30 |
Medica Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $89.13 | Professional | None | $12.02 | $14.13 | $89.13 |
Network Health Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $19.50 | Facility | None | $13.80 | $13.80 | $19.50 |
Network Health Setting Professional Modifier None Typical Low $17.78 Median $20.42 Typical High $20.42 | Professional | None | $17.78 | $20.42 | $20.42 |
Prevea360 Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $26.92 | Facility | None | $12.30 | $12.30 | $26.92 |
Prevea360 Setting Professional Modifier None Typical Low $18.62 Median $24.55 Typical High $24.55 | Professional | None | $18.62 | $24.55 | $24.55 |
Quartz Setting Professional Modifier None Typical Low $13.80 Median $22.39 Typical High $35.48 | Professional | None | $13.80 | $22.39 | $35.48 |
Quartz Setting Facility Modifier None Typical Low $19.05 Median $35.48 Typical High $35.48 | Facility | None | $19.05 | $35.48 | $35.48 |
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 $15.49 Median $15.85 Typical High $19.05 | Professional | None | $15.49 | $15.85 | $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 $13.80 Median $15.49 Typical High $18.20 | Professional | None | $13.80 | $15.49 | $18.20 |
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 $6.03 Typical High $41.69 | Professional | 52 · Reduced service | $5.89 | $6.03 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.40 Typical High $16.60 | Professional | 53 · Discontinued | $2.34 | $2.40 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.78 Typical High $12.59 | Professional | 55 · Aftercare only | $1.78 | $1.78 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.20 Typical High $8.32 | Professional | 56 · Pre-op care only | $1.17 | $1.20 | $8.32 |
Where Wisconsin sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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· 22nd of 51
$13.49
AK $20.89KY $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.