How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $6Professionalmedian $2 · 10th to 90th $2 to $4
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 $2.19 Median $2.19 Typical High $5.01 | Facility | None | $2.19 | $2.19 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.19 Typical High $3.98 | Professional | None | $2.14 | $2.19 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.24 | Professional | None | $2.14 | $2.14 | $3.24 |
CareSource Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $3.55 | Professional | None | $2.29 | $2.29 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $5.13 Typical High $6.46 | Facility | None | $3.09 | $5.13 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.80 | Professional | None | $2.14 | $2.14 | $3.80 |
DeanCare Setting Facility Modifier None Typical Low $1.66 Median $2.29 Typical High $5.01 | Facility | None | $1.66 | $2.29 | $5.01 |
DeanCare Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $4.57 | Professional | None | $2.95 | $2.95 | $4.57 |
Medica Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $13.80 | Facility | None | $1.95 | $1.95 | $13.80 |
Medica Setting Professional Modifier None Typical Low $1.95 Median $2.14 Typical High $11.48 | Professional | None | $1.95 | $2.14 | $11.48 |
Network Health Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.37 | Facility | None | $4.27 | $4.27 | $4.37 |
Network Health Setting Professional Modifier None Typical Low $2.75 Median $3.16 Typical High $3.16 | Professional | None | $2.75 | $3.16 | $3.16 |
Prevea360 Setting Facility Modifier None Typical Low $1.66 Median $2.29 Typical High $5.01 | Facility | None | $1.66 | $2.29 | $5.01 |
Prevea360 Setting Professional Modifier None Typical Low $1.86 Median $4.57 Typical High $4.57 | Professional | None | $1.86 | $4.57 | $4.57 |
Quartz Setting Professional Modifier None Typical Low $2.14 Median $3.89 Typical High $5.89 | Professional | None | $2.14 | $3.89 | $5.89 |
Quartz Setting Facility Modifier None Typical Low $3.55 Median $6.46 Typical High $6.46 | Facility | None | $3.55 | $6.46 | $6.46 |
Quartz Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Security Health Setting Professional Modifier None Typical Low $2.09 Median $2.88 Typical High $3.47 | Professional | None | $2.09 | $2.88 | $3.47 |
The Alliance Setting Professional Modifier None Typical Low $3.47 Median $4.17 Typical High $5.89 | Professional | None | $3.47 | $4.17 | $5.89 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.40 Typical High $11.75 | Professional | None | $2.19 | $2.40 | $11.75 |
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 $1.07 Median $1.10 Typical High $15.14 | Professional | 52 · Reduced service | $1.07 | $1.10 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.44 Typical High $6.03 | Professional | 53 · Discontinued | $0.43 | $0.44 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.33 Typical High $4.47 | Professional | 55 · Aftercare only | $0.32 | $0.33 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $3.02 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $3.02 |
Where Wisconsin sits
The same service costs 1.9 times more in Wyoming than in Maine. 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· 15th of 51
$2.19
WY $4.07ME $2.14
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.